4. Why was she hypoprothrombinemic?
a. The lack of bile in the duodenum decreased the
absorption of vitamin K, a factor necessary for the
synthesis of prothrombin.
b. The vomiting caused a vitamin K deficiency; vita-
min K is necessary for the synthesis of several
clotting factors.
c. The stones injured the common bile duct, causing
it to bleed and depleting the body of clotting fac-
tors such as prothrombin.
d. Prothrombin is synthesized by the gallbladder, so
its production decreases because of the inflamma-
tion.
5. What is the most likely consequence of hypopro-
thrombinemia?
a. jaundice
b. hypertension
c. bleeding
d. hemolysis
6. Vitamin K was given to
a. stimulate the hepatic synthesis of prothrombin.
b. dissolve the stones.
c. stimulate the kidneys to excrete the excess biliru-
bin.
d. relieve the pain.
7. Why had her stools become clay colored?
a. Undigested fat in the duodenum makes the stools
appear light.
b. Because the stones had blocked the common bile
duct, there was a decreased amount of bile pigment
in the stool.
c. Excess bile in the duodenum makes the stools ap-
pear light.
d. Small gray stones washed into the stool from the
common bile duct, thereby changing its color.
PUZZLE
