10. Breakpoint #4

Breakpoint #4

Unresolved issues: Even with severe vitamin C deficiency, why did the patient bleed (down to a Hct of 14%) into her knee/thigh?

1) Could there have been some "occult" trauma?

2) Are we confident that she doesn't have a congenital bleeding disorder?

3) What about those spherocytes, ­ bili and ­ LDH?

4) Can this all be explained by vitamin K deficiency? How did she become vitamin K-deficient?