MRCP2-2305

MRCP2-2305

A 47-year-old male presented for pre-operative assessment prior to a routine laparoscopic cholecystectomy. He had a history of a previous surgery for a broken leg. His only medication was for high blood pressure. He reported occasional right upper quadrant pain due to gallstones but was otherwise healthy. The following routine blood tests were obtained:

Haemoglobin: 140 g/L (115 – 165)
White cell count: 8.2 ×109/L (4 – 11)
Neutrophils: 5.5 ×109/L (1.5 – 7)
Lymphocytes: 1.8 ×109/L (1.5 – 4)
Monocytes: 0.3 ×109/L (0 – 0.8)
Eosinophils: 0.2 ×109/L (0.04 – 0.4)
Basophils: 0.1 ×109/L (0 – 0.1)
Platelet count: 230 ×109/L (150 – 400)
Prothrombin time: 12.8 s (11.5 – 15.5)
APTT: 78 s (30 – 40)
Fibrinogen: 4.8 g/L (1.8 – 5.4)
APTT (50:50 mix with normal plasma): 72 s

The laparoscopic cholecystectomy was performed without any complications. What is the most likely interpretation of these laboratory results?