MCQ – 88211

 A 16-year-old girl has suffered from severe celiac disease for years and reports continued steatorrhea. She suddenly develops abdominal pain in the right lower quadrant. A complete blood count shows a hemoglobin level of 14 g/dL, WBC of 18,000/μL, with 84% neutrophils, and a platelet count of 280,000/μL. A diagnosis of appendicitis is made, and tests before surgery reveal a prolonged prothrombin time of 17 seconds (control = 2). What is the most likely cause of her coagulation problem?

Correct Answer � D Explanation

Answer : D Vitamin K deficiency

Vitamin K deficiency is common in severe fat malabsorption, as seen in celiac sprue and biliary tract obstruction.

The destruction of intestinal flora by antibiotics may also result in vitamin K deficiency. Vitamin K, which confers calcium-binding properties to certain proteins, is important for the activity of four clotting factors: prothrombin, factor VII, factor IX, and factor X. Deficiency of vitamin K can be serious because it can lead to catastrophic bleeding.