In a patient with cirrhosis, what is expected regarding PT/PTT and platelet count?

• A. PT/PTT decreased, Platelet count increased
• B. PT/PTT increased, Platelet count decreased
• C. PT/PTT normal, Platelet count normal
• D. PT/PTT increased, Platelet count normal

Answer: (B)

In a patient with cirrhosis, the expected findings regarding prothrombin time (PT/PTT) and platelet count are indeed that both PT/PTT are increased and the platelet count is decreased.

Cirrhosis can lead to impaired liver function, which is crucial for synthesizing many of the clotting factors necessary for coagulation. The liver produces clotting factors such as fibrinogen, prothrombin, factor V, and factors VII, IX, and X, among others. When cirrhosis occurs, the liver's ability to produce these factors is compromised, leading to a prolonged PT and PTT due to the reduction in functional clotting factors circulating in the blood.

In addition, cirrhosis can cause portal hypertension, which can lead to splenomegaly. An enlarged spleen can sequester platelets, resulting in a decrease in the overall platelet count. The combined effect of decreased clotting factors and decreased platelet count predisposes patients with cirrhosis to a bleeding tendency, which is reflected in the increased PT/PTT and decreased platelet count.

Understanding these physiological changes in cirrhosis helps in the management and monitoring of such patients for potential bleeding complications.