In a patient with a history of alcoholism and cirrhosis, what are the expected laboratory findings for PTT, PT, and platelet count?

• A. Increased PT/PTT, Normal Platelets
• B. Normal PT/PTT, Decreased Platelets
• C. Increased PT/PTT, Decreased Platelets
• D. Normal PT/PTT, Normal Platelets

Answer: (C)

In a patient with a history of alcoholism and cirrhosis, the expected laboratory findings include increased prothrombin time (PT) and activated partial thromboplastin time (PTT), along with decreased platelet count.

Cirrhosis significantly impacts the liver's ability to synthesize coagulation factors, which leads to an increase in both PT and PTT because the liver is responsible for producing many of the clotting factors involved in the coagulation cascade. These factors include prothrombin and factors V, VII, IX, and X, among others. As liver function deteriorates, the production of these factors decreases, resulting in prolonged clotting times reflected by the increased PT and PTT.

Alcoholism also contributes to thrombocytopenia (decreased platelet count) due to several mechanisms. Chronic alcohol consumption can directly suppress bone marrow function, leading to reduced platelet production. Additionally, in patients with cirrhosis, splenic enlargement due to portal hypertension can sequester platelets, further lowering the platelet count.

Combining these aspects, the laboratory findings would demonstrate an increase in both PT and PTT alongside a decrease in platelet count, which aligns with the selected answer.