DIC Flashcards
Causes of DIC?
Acquired
- Malignancy
Obstetric
- Ecclampsia
- Placental abruption
Vascular
- Kasabach meritt syndrome
SEPSIS !!!!!! NEVER FORGET SEPSIS !!!!!
Pathology?
Systematic activation of clotting -> Inappropriate thrombosis -> Depletion of platelets + coag factors -> Obstruction of organs -> Massive haemorrhage and organ failure
What is constantly happening in DIC?
Fibrinogenesis
Consumption of clotting factors
Typical presentation?
” 1 y/o boy with fever and vomiting presents with diffuse skin rash and abdominal petechiae. He is irritable and tachycardic. FBC shows leukocytosis, very low platelets and an increased aPTT and PTT. Blood cultures show a gram -ve cocci. Protein C activity is low. “
What gram -ve cocci may be responsible?
Neisseria Meningitidis
Symptoms?
Circulatory collapse
- Hypotension
- Tachycardia
- Oliguria
Purpura and ecchymosis
What is the diagnosis of DIC based on?
Purpura/ecchymosis/oozing/haematuria
AT THREE DIFFERENT SITES
Investigations?
FBC
aPTT/PTT
D-dimer/fibrin degredation products
What is seen on FBC?
Thrombocytopenia
What is seen on PTT/aPTT?
Both prolonged
DDx?
ITP
Liver failure
HELLP
Treatment?
Treat underlying cause
FFP
Cryoprecipitate (if fibrinogen low)
Tranexamic acid
