All are impoant mechanisms in the formation of lithogenic bile:: (A) Increased biliary secretion of cholesterol, (B) Increased activity of HMG CoA reductase, (C) Clofibrate, (D) Low calorie and cholesterol rich diet
Answer is D. Mechanisms in the formation of lithogenic (stone-forming) bile. The most impoant is increased biliary secretion of cholesterol. This may occur in association with obesity, the metabolic syndrome, high-caloric and cholesterol-rich diets, or drugs (e.g., clofibrate) and may result from increased activity of hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 2617