A 44-year-old female patient presents to the emergency department with abnormal bleeding and abdominal pain that is later attributed to gallbladder disease
Which of the following diagnoses would the medical team be most justified in suspecting as a cause of the patient's bleeding?
A) Excess calcium
B) Vitamin K deficiency
C) Hemophilia B
D) Idiopathic immune thrombocytopenic purpura (ITP)
Ans: B
Feedback: Factors VII, IX, and X and prothrombin require the presence of vitamin K for normal activity. Vitamin K deficiency may result from impaired fat absorption caused by liver or gallbladder disease. Calcium, factors X and V, and platelet phospholipids combine to form prothrombin activator, which then converts prothrombin to thrombin. Excess calcium could result in increased formation of blood clots. Hemophilia B is a hereditary disorder. Half of the cases of ITP occur as an acute disorder in children; ITP in adults is a chronic disorder with insidious onset.
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