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* p4
 #259850  
  k80 - 01/11/08 02:11
 
  .A 6-day-old girl who was born at home is being evaluated for bruising and gastrointestinal bleeding. Laboratory findings include partial thromboplastin time and prothrombin time, greater than 2 minutes; serum bilirubin, 4.7 mg/dL; alanine aminotransferase, 18 mg/dL; platelet count, 330,000/mm3; and hemoglobin, 16.3 g/dL. Which of the following is the most likely cause of her bleeding?

a)Factor VIII deficiency
b)Factor IX deficiency
c)Idiopathic thrombocytopenic purpura
d)Liver disease
e) Vitamin K deficiency
 
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* Re:p4
#1120684
  darkhorse - 01/11/08 02:45
 
  eeee  
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* Re:p4
#1120689
  abrahem - 01/11/08 02:54
 
  E..  
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* Re:p4
#1120846
  pranav - 01/11/08 09:38
 
  It's E.
Newborn babies don't have Vitamin K reserves. Usually it's produced by normal commensal flora of intestine. Until that time , babies are vulnerable. That's why all the hospital born babies are given Vitamin K Injection by IM route.

Home born babies don't get this inj, as in this case. So Vit K is not produced and Vit K dependant factors are not produced and therby Haemorhagic disease of New born.

I WANT TO EXTEND THE DISCUSSION HERE. IS IT POSSIBLE FOR A BABY GIRL TO HAVE HAEMOPHILIA?????
 
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* Re:p4
#1120929
  multifactorial - 01/11/08 11:03
 
  E.  
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* Re:p4
#1120935
  multifactorial - 01/11/08 11:04
 
  ya it is possible for a person to have hemophilia right from birth as it is X-linked recessive so you have it right from birth.  
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* Re:p4
#1120938
  hyatt - 01/11/08 11:05
 
  Multi--shouldnt the female be a carrier-----MAle will express the dz from birth  
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* Re:p4
#1120946
  pranav - 01/11/08 11:08
 
  This question is the essence of a big question being asked in MRCPCH few years ago. any other views before I answer this q?  
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* Re:p4
#1120954
  darkhorse - 01/11/08 11:11
 
  yess.....in case of unfavourable lyonisation  
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* Re:p4
#1120959
  hyatt - 01/11/08 11:12
 
  go ahead with the answer  
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* Re:p4
#1120967
  pranav - 01/11/08 11:17
 
  Lyonisation is good response. But even without lyonbisation, it's possible.

In Turner's syndrome( XO), it's possible. This question was asked by my consultant 4 years ago, when I first arrived UK. This was asked in MRCPCH.

Any comments?
 
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