Condition- DIC

Question 1

What is the main cause of DIC?

Answer 1

Sepsis

Question 2

List some of the causes of DIC

Answer 2

1. Sepsis
2. Malignancy
   
   • AML- acute
   • GI, breast, lung and AAA malignancy- chronic
3. Obstetric complications- Pre-ecamplsia, intra-uterine death
4. Surgery/Trauma/Death

Question 3

Which haematological cancer can cause DIC?

Answer 3

Acute Myeloid Leukaemia- the myeloid cells activate the clotting cascade

Question 4

Explain what causes the widespread clotting seen in DIC

Answer 4

• Endothelial damage => activation of clotting cascade and fibrin clot formation
• In DIC- the balance between coagulation and fibrinolysis is tipped by a pro-coagulant factors (e.g. Tissue factor, lipopolysaccharides)
• Results in explosive widespread clots => necrosis + end organ damage
• => depletion of clotting factors => increased bleeding tendency

Question 5

List some of the signs and symtpoms of DIC

Answer 5

• Symptoms of Increased Clotting + organ necrosis
  
  • Lungs- SOB
  • Brain- confusion
  • Kidneys- AKI symptoms
• Symptoms of increased bleeding
  
  • Epistaxis
  • Mucosal bleeding
  • Petechiae/purpura/ echymyoses
• Symptoms of MAHA: jaundice, anaemia

Question 6

What would you see in the bloods of someone with DIC?

Answer 6

• Low Hb, Normal MCV
• High aPTT and PT (signs of factor depletion)
• Low platelets
• Low fibrinogen, high FDP and D-dimer (signs of fibrinolysis)

Question 7

What does aPTT measure?

Answer 7

Extinsic and Common pathway

Question 8

What does PT measure?

Answer 8

Intrinsic and common pathway