<prompt> Both APTT and PT are prolonged in which conditions?Factor II deficiencyFactor XIII deficiencyHeparin administrationThrombocytopenia  <response>: ANSWER: A Factor II deficiencyREF: Mastery of Surgery by Josef E. Fischer, K. I. Bland, 5th edition Part I page 90, Saint-Frances guide: clinical clerkship in outpatient medicine. Page 434 8; 235, Harrison 17th ed table 59-4See APPENDIX-50 below for BLE EDIN GC O AG U L ATI ON DISORDERS and APPROACH TO A PATIENT WITH BLEEDING DISORDER APPENDIX - 50BLEEDINGCOAGULATION DISORDERSTable from Mastery of Surgery by Josef E. Fischer, K. I. Bland, 5th edition Part I page 90, Bleeding_diathesisConditionProthrombinTimePartialThromboplastinTimeBleedingTimePlateletCountAspirinNormalNormalProlongedNormalCongenital afibrinogenemiaProlongedprolongedProlongedNormalDisseminated intravascular coagulationProlongedprolongedprolongedDecreasedEarly Liver failureProlongedNormalNormalNormalEnd-stage Liver failureProlongedprolongedprolongedDecreasedHaemophilia A Factor 8NormalProlongedNormalNormalHaemophilia B Factor 9 Christmas diseaseNormalProlongedNormalNormalParahemophelia factor 2,5,10ProlongedProlongedNormalNormalFactor 7 deficiencyProlongedNormalNormalNormal! ThrombocytopeniaNormalNormalProlongedDecreasedBernard-Soulier syndromeNormalNormalProlongedDecreasedGlanzmann s thrombastheniaNormalNormalProlongedNormalUremiaNormalNormalProlongedNormalVitamin K deficiency or warfarinProlongedProlongedNormalNormalVon Willebrand diseaseNormalNormalProlongedNormalAPPROACH TO A PATIENT WITH BLEEDING DISORDER Obtain PT PTT and Platelet count Increased PT, Normal PTTNormal PT,Both PT Both PT PTT normalIncreased PTTPTT increasedPlatelet count Early DIC Liver disease Warfarin therapy Mild Vitamin K deficiency Factor 7 deficiency Coagulation factor deficiency Coagulation factor inhibitor Antiphospholipid antibody Heparin therapy Severe DIC Severe liver disease Warfarin overdose Severe vitamin K deficiency Factor 2, 5,10 deficiency Heparin therapy 90,000pL Do Bleeding time 90,000uL ThrombocytopeniaSee extension of table below Do bleeding timeNormal bleeding timeIncreased bleeding time Deficiency of inhibitors of fibrinolysis Dysfibrinogenemia Factor 13 deficiencyPlatelet dysfunctionAcquiredInherited Severe renal disease Severe liver disease Myeloploreferative disorder Autoantibodies Paraprotenemia DIC vWD Bernard Soulier disease Glanzmann thrombasthenia 