ACQUIRED COAGULATION DISORDERS

Question 1

D.I.C

Reduction in __________ due to __________ initiated by a variety of events

Answer 1

circulating clotting factors

intravascular thrombosis

Question 2

PATHOGENESIS of DIC

 Release of tissue thromboplastin
→ activation of ——— system e.g. ____ trauma, ______ complications, ________ episodes and malignancies.

 - Severe endothelial damage
→ activation of ______ system e.g. ______,_________.

 Direct ______________ e.g.
septicaemia

 Secondary activation of ————-
→ _______

_________ of clotting factors and platelets

Answer 2

extrinsic; surgical; obstetric; acute haemolytic

intrinsic; Gram-ve septicaemia, burns

induction of platelet aggregation

fibrinolysis; FDP

Consumption

Question 3

Haematological findings of DIC:

 - Thrombo________
 - Blood film shows ___________
etc

 - ________ Bleeding time , ______ PT , _________PTT

 - _________ Fibrinogen

_______ factor V and VIII

 - _____ Present

Answer 3

cytopenia

redcell fragments

Increased, increased, very increased

Decreased; decreased

FDP

Question 4

AETIOLOGY OF DIC
 Obstetric Accidents

◼___________
◼__________
◼________
◼ IUD

Answer 4

Abruptio placenta

amniotic fluid embolism

Eclampsia

Question 5

AETIOLOGY OF DIC

List 9

Answer 5

Septicaemia, gram-ve meningococcal

Haemolytic transfusion reaction

Liver disease especially liver failure

Acute promyelocytic leukaemia

Massive surgery

Obstetric Accidents

Disseminated Ca

Snake bite

Severe hypersensitivity reaction

Question 6

CLINICAL FEATURES OF D.I.C

Three Clinical forms
(a)________ DIC

(b)_____________ DIC

(c)________ DIC

Answer 6

Compensated

Chronic or subacute

Acute

Question 7

CLINICAL FEATURES OF D.I.C
Three Clinical forms
(a) Compensated DIC - ___ symptoms,
only demonstrated in the ________

(b) Chronic or subacute DIC -________ symptoms like _______ and ______

(c) Acute DIC - Presents with _________ and _________

Answer 7

No; laboratory

Occasional mild; bruises and progressive organ failure

widespread bruising and bleeding

Question 8

Majority of D.I.C fall into which category?

Compensated, chronic, or acute ?

Answer 8

Compensated and chronic

Question 9

DIC

Symptoms and signs may be related in
most instance to the condition
causing the DIC.

T/F

Answer 9

T

Question 10

Symptoms due to DIC persey

-_______
-____________due to ischaemia
- _____________________________

Answer 10

Bleeding

Organ damage

Micro angiopathic haemolytic
anaemia

Question 11

DIAGNOSIS OF COMPENSATED
DIC

••Test to detect platelet activation
–_______
-__________

••Test to show increased coagulation
factor activation and thrombin generation.

-increased ________level
-Decreased level of two main inhibitory
proteins (_______,________)

Answer 11

P/F factor Cf; Thromboxane A2

fibrinopeptide A

Antithrombin III, Protein C

Question 12

Treatment of DIC

Principles
(a)________________
(b) ___________ of _______ and ______
(c) _______ of the Clotting process with _____ or other agents.

Answer 12

elimination of primary cause of DIC

Replacement of coagulation factors and platelets

Inhibition; heparin

Question 13

TREATMENT OF ACUTE DIC

 General support measures
–______
- blood
-______ care
- Antibiotics

 Elimination of _________

 Replacement of coagulation factors and platelets
◼ _____
◼______
◼ _______
 Repeat above as indicated by lab or clinical observation.

___________________

Answer 13

fluids; respiratory

primary cause of DIC

FFP; Cryo ppt; Platelets

Inhibition of clotting process with Heparin or other agents

Question 14

Bleeding associated with Liver
disease, why ?

__________ develops in end stage
liver disease
 Abnormal ______ function
 Reduced platelet production due to
__________
 Acquired ______________

Answer 14

Renal failure

endothelial

thrombopoietin

platelet dysfunction