Acquired defects of factors II, V, VII, IX and X

Acquired defects of factors II, V, VII, IX and X arise in advanced liver diseases, [vitamin K]] deficiency/inhibition.
 * Absorption disorder of vit. K: obstructive jaundice, malabsorption syndrome (pancreatic / intestinal origin),
 * coumarin preparations act as inhibitors of vit. K (warfarin, see figure),
 * in  liver diseases, the production of f. II, VII, IX, X, V decreases gradually; u go ahead conditions complex disorder of hemostasis + in addition thrombocytopenia (with splenomegaly), increased fibrinolytic activity (portocaval anastomoses + ↓ detoxification capabilities of the liver),
 * in liver diseases, hemorrhagic conditions of varying severity, threat to hl. bleeding into the GIT.

Therapy

 * Lack of vit. K / overdose of coumarin → administration of vit. K (Kanavit),
 * at hep. replacement disease: K-plasma, prothrombin complex concentrates, fresh frozen plasma,
 * antifibrinolytics + glucocorticoids.

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