DIC Flashcards
What is the central mechanism underlying DIC?
A) Anticoagulation due to increased protein C activity
B) Uncontrolled generation of thrombin by multiple mechanisms
C) Excessive fibrinolysis caused by tissue plasminogen activator (tPA) overactivity
D) Deficiency in von Willebrand factor (VWF) cleavage
Answer: B) Uncontrolled generation of thrombin by multiple mechanisms
Rationale: The overproduction of thrombin, along with impaired anticoagulant systems and fibrinolysis, is central to the pathophysiology of DIC.
What is the most common clinical manifestation of DIC?
A) Deep vein thrombosis
B) Petechiae, ecchymoses, and systemic bleeding
C) Fever and lymphadenopathy
D) Isolated gastrointestinal bleeding
Answer: B) Petechiae, ecchymoses, and systemic bleeding
Rationale: DIC commonly presents with bleeding symptoms ranging from petechiae to severe hemorrhage, due to clotting factor and platelet consumption.
What laboratory findings are typical in acute DIC?
A) Elevated fibrinogen and normal d-dimer
B) Thrombocytopenia, elevated d-dimer, prolonged PT, and low fibrinogen
C) Normal PT and aPTT with high platelet count
D) Decreased fibrin degradation products (FDPs)
Answer: B) Thrombocytopenia, elevated d-dimer, prolonged PT, and low fibrinogen
Rationale: Acute DIC is characterized by thrombocytopenia, increased fibrin degradation products (e.g., d-dimer), and prolonged clotting times due to coagulation factor depletion.
What is the main characteristic of chronic DIC?
A) Severe thrombocytopenia and bleeding
B) Low-grade, compensated coagulation abnormalities with minimal symptoms
C) Severe thrombotic occlusions of large vessels
D) Hyperfibrinolysis with profound hemorrhage
Answer: B) Low-grade, compensated coagulation abnormalities with minimal symptoms
Rationale: Chronic DIC is characterized by mild thrombocytopenia, elevated d-dimers, and red cell fragmentation without significant bleeding.
In the management of acute DIC, what is the priority?
A) Correcting the underlying condition
B) Immediate platelet transfusion for all patients
C) Administering anticoagulants to prevent thrombosis
D) Initiating fibrinolytic therapy
Answer: A) Correcting the underlying condition
Rationale: The most important step in managing DIC is addressing the underlying cause (e.g., sepsis, trauma, malignancy) to control the process.
What is the primary focus in the management of DIC?
A) Correcting coagulation abnormalities with transfusion therapy
B) Treating the underlying disease causing DIC
C) Administering high-dose anticoagulants to control thrombosis
D) Using antifibrinolytics to prevent further bleeding
Answer: B) Treating the underlying disease causing DIC
Rationale: Managing the underlying condition is essential for controlling and eliminating DIC. Supportive therapy addresses symptoms but does not resolve the root cause.
When is platelet transfusion indicated in patients with DIC?
A) Always, regardless of platelet count
B) When platelet counts are <10,000–20,000/μL or when active bleeding is present
C) Only if platelet counts are below 50,000/μL
D) Only if there is evidence of thrombosis
Answer: B) When platelet counts are <10,000–20,000/μL or when active bleeding is present
Rationale: Platelet transfusion is necessary for severe thrombocytopenia or active bleeding but not for mildly abnormal coagulation parameters.
What is the target fibrinogen level in patients with DIC who require transfusion support?
A) >100 mg/dL
B) >150 mg/dL
C) >200 mg/dL
D) Normal levels (350–450 mg/dL)
Answer: B) >150 mg/dL
Rationale: Fibrinogen levels should be maintained at >150 mg/dL to minimize bleeding risk during invasive procedures or in actively bleeding patients.
What is the role of cryoprecipitate in managing DIC?
A) It provides platelets for thrombocytopenia
B) It serves as a concentrated source of fibrinogen and coagulation factors
C) It prevents thrombosis by inhibiting fibrin formation
D) It acts as an antifibrinolytic agent
Answer: B) It serves as a concentrated source of fibrinogen and coagulation factors
Rationale: Cryoprecipitate is used to replace fibrinogen and other coagulation factors in bleeding patients with DIC.
