,IMPRESSION AND PLAN:,  Markedly elevated PT/INR despite stopping Coumadin and administering vitamin K.  I will check mixing studies to see if she has deficiency, which could be due to poor production given her elevated LFTs, decreased albumin, and decreased pre-albumin.
,IMPRESSION AND PLAN : , Markedly elevated PT / INR despite stopping Coumadin and administering vitamin K. I will check mixing studies to see if she has deficiency , which could be due to poor production given her elevated LFTs , decreased albumin , and decreased pre - albumin .