**Core Concept**
The question tests the student's understanding of the physiological changes that occur in the body during starvation, particularly focusing on the gallbladder. In starvation, the body undergoes various adaptations to conserve energy and maintain vital functions.

**Why the Correct Answer is Right**
During starvation, the gallbladder becomes distended due to the accumulation of bile. This occurs because the lack of food intake leads to a decrease in the release of cholecystokinin, a hormone that normally stimulates the gallbladder to contract and release bile into the intestine. As a result, the bile remains in the gallbladder, causing it to become distended.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because the gallbladder does not shrink in starvation.
**Option B:** This option is incorrect because the gallbladder does not remain unchanged in starvation.
**Option C:** This option is incorrect because the gallbladder does not become smaller in starvation.

**Clinical Pearl / High-Yield Fact**
In cases of starvation, the distended gallbladder can be a significant finding at autopsy, helping to confirm the cause of death. This knowledge is crucial for forensic pathologists.

**Correct Answer:** D. Distended