A patient tells you she has been suffering from chronic celiac sprue. She reports bulky stools, with distension, flatus, fatigue, and bleeding from her gums. She has red spots on her abdomen, arms,...

A patient tells you she has been suffering from chronic celiac sprue. She reports bulky stools, with distension, flatus, fatigue, and bleeding from her gums. She has red spots on her abdomen, arms, and legs. She has not adhered to her diet for some time.What is the most important immediate step to take?

A. A shot of vitamin K

B. You should have a long discussion with her about the importance of her adherence to her diet and participation in her own healthcare

C. Small intestinal biopsy

D. Screen other family members for sprue

E. Test stool for fecal fat