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Multiple Choice Questions « Return to contents list Chapter 20, Question 1.20.1 Which one of the following is the most common cause of late-onset haemorrhagic disease (vitamin K deficiency bleeding)? A Neonatal septicaemia.[Feedback :- Septicaemia can cause DIC and bleeding, but this is normally around the time of the acute episode.] B Complete oral (instead of IM) vitamin K administration.[Feedback :- Oral vitamin K should be just as effective as IM if administered properly. Three doses (birth, 4–7 days and 1 month) are required, and failure to complete the course is now the most common cause of late-onset haemorrhagic disease in exclusively breastfed infants.] C Formula feeding.[Feedback :- Formula is supplemented with vitamin K.] D Cystic fibrosis.This is the Correct Answer [Feedback :- Infants with undiagnosed cystic fibrosis can have malabsorption of the fat-soluble vitamins (A, E, D and K), and this would be the most likely cause of late-onset haemorrhagic disease in this list.] E Hypoxic–ischaemic encephalopathy (HIE).[Feedback :- HIE can cause DIC and bleeding, but this is normally around the time of the acute episode.]