DIC

Question 1

What is DIC?

Answer 1

disseminated intravascular coagulation
activation of coagulation pathways resulting in formation of intravascular thrombi and depletion of platelets and coagulation factors

Question 2

What are the causes of DIC?

Answer 2

sepsis
major trauma/burn/organ destruction
obstetric complications e.g. amniotic fluid embolism or haemolytic, HELLP
malignancy

Question 3

What investigations would u do - what would you find

Answer 3

1. Platelet count - decreased due to XS consumption
2. PT, aPTT - prolonged
3. Fibrinogen - decreased due to XS consumption
4. D-dimer - elevated

Question 4

What is a critical mediator of DIC?

Answer 4

tissue factor
present on the surface of many cell types and not generally in contact with the general circulation but is exposed after vascular damage

Question 5

explain the underlying pathophysiology of DIC

Answer 5

Dysregulation of coagulation and fibrinolysis = widespread clotting and bleeding
all the platelets are depleted so means more bleeding

Question 6

How does DIC present?

Answer 6

• oliguria, hypotension, tachycardia
• purpura fulminans, gangrene, acral cyanosis (extremities)
• delirium or coma

Question 7

What is the treatment of acute DIC?

Answer 7

Treat underlying disorder

+/- platelets + coag factors (FFP) and coag inhibitors

Question 8

What is the treatment of chronic dic

Answer 8

Treat underlying disorder
Heparin
Antifibrinolytic agents e.g. tranexamic acid