Disseminated Intravascular Coagulation

benryan95's version from 2015-10-22 18:53

Section 1

Question Answer
What is meant by DIC?An acquired syndrome caused by activation of coagulation pathways, resulting in formation of intravascular thrombi and depletion of coagulation factors + platelets.
What may thrombi from DIC lead to?Vascular obstruction/ischaemia and multi organ failure
What is highly suggestive of DIC?Generalised bleeding, evidenced by at least 3 unrelated sites
What may trigger DIC?Sepsis, severe infection, major trauma, burns, malignancies, obstetric disorders, organ failure, vascular disorders, toxic and immunological reactions
Can DIC be acute, chronic, or both?Both
What is acute DIC characterised by?rapid-onset generalised bleeding + thrombosis, hypoperfusion, infarction and end organ damage
What is chronic DIC characterised by?subacute bleeding and diffuse thrombosis
What may DIC present with?Oliguria, hypotension, tachycardia, purpura, gangrene, acral cyanosis, delirium, coma, haematuria
What tests should be ordered for DIC?Platelet count, Prothrombin time, fibrinogen, D dimer
What would platelet count in DIC be?Decreased
What would PT be in DIC?Often prolonged
What would fibrinogen be in DIC?Decreased
What would D dimer be in DIC?Icreased

Section 2

Question Answer
What makes a DIC overt?A low platelet count, an increased in fibrin-related markers, a prolonged PT time, and a decreased fibrinogen level
What is the first line treatment in DIC with low bleeding risk?Treat underlying disorder
What is the first line treatment in DIC with high bleeding risk?Treat underlying disorder, plus platelets and coagulation factors + coagulation inhibitors (fresh frozen plasma)
What are complications of DIC?Acute renal failure, life-threatening haemorrhage, cardiac tamponade, haemothorax, intracerebral haemorrhage, gangrene, loss of digits

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