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Review Question - QID 8334

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QID 8334 (Type "8334" in App Search)
A 48-year-old man who is scheduled to undergo total knee replacement has an X-linked clotting disorder that leads to abnormal bleeding and recurrent, spontaneous hemarthrosis. Before undergoing surgery, he should have replacement therapy of

protein C and S.

3%

18/560

vitamin K.

5%

28/560

von Willebrand factor.

12%

69/560

factor VIII.

79%

443/560

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Hemophilia A is an X-linked recessive deficiency of factor VIII that can lead to significant bleeding problems including recurrent spontaneous hemarthroses that can lead to synovitis and joint destruction. von Willebrand disease is a lack of von Willebrand factor that leads to decreased platelet aggregation; more commonly patients have mucosal bleeding and not hemarthroses. Vitamin K deficiency is not hereditary; it is typically attributable to inadequate dietary intake, malabsorption, and loss of storage sites from hepatocellular disease. Protein C and S deficiencies are autosomal-dominant diseases that lead to thrombosis, not bleeding, as protein C and S shut off thrombin formation.

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