Which of the following proteins is the best test to distinguish moderate to severe liver disease from
a. Factor V concentration
b. Factor VII concentration
c. Factor VIII concentration
d. Factor IX concentration
ANS: A
Factor V is not vitamin K dependent, but it is produced in the liver so it is decreased in moderate to severe liver disease. Factors VII and IX are both vitamin K dependent, so they are decreased in both liver disease and vitamin K deficiency. Factor VIII is not decreased in either liver disease or vitamin K deficiency; in fact, because it is an acute phase reactant, it may actually be elevated in mild to moderate liver disease.
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