Disseminated Intravascular Coagulation Flashcards
What is DIC?
DIC is a serious disorder occurring in response to an illness or disease process which results in dysregulated blood clotting.
DIC stands for Disseminated Intravascular Coagulation.
What are the simultaneous manifestations of DIC?
Paradoxical bleeding and thrombosis.
This occurs due to inappropriate activation of clotting and fibrinolytic systems.
What triggers the development of DIC?
Triggers can be infectious or non-infectious, including:
* sepsis
* malignancy
* severe burns.
Infectious triggers often involve a systemic inflammatory response.
What is the process of DIC activation?
- Trigger → systemic inflammatory response → expression of pro-coagulant factors
- Intravascular fibrin deposition and platelet aggregation → microvascular thrombosis → ischaemia, necrosis, multi-organ failure → consumption coagulopathy & thrombocytopenia → spontaneous bleeding.
This highlights the cascade of events leading to DIC.
List some causes of DIC.
Causes include:
* shock
* sepsis or severe infection
* major trauma or burns
* malignancies (especially acute promyelocytic leukemia)
* obstetric emergencies
* severe immune-mediated reactions
* severe organ dysfunction.
Each cause can trigger the coagulopathy seen in DIC.
What is a key clinical feature of DIC?
Bleeding from unusual sites such as ears, nose, GI tract, and respiratory tract.
Bleeding from three unrelated sites is highly suggestive of DIC.
What are some examination findings in DIC?
Examination findings may include:
* signs of haemorrhage
* petechiae or purpura
* livedo reticularis
* purpura fulminans
* confusion
* signs of circulatory collapse.
These findings can indicate the severity of the condition.
What is the ISTH score used for in DIC?
The ISTH score assesses:
* platelet count (decreased)
* d-dimer value (increased)
* prothrombin time (increased)
* APTT (increased)
* fibrinogen levels (decreased).
This scoring helps in diagnosing DIC.
What are the main goals of managing DIC?
- Manage/treat the underlying disorder (stop the trigger)
- Supportive treatment (restore normal coagulation).
Supportive treatment may include platelet transfusions and clotting factors.
What are some complications of DIC?
Complications include:
* multi-organ failure
* life-threatening haemorrhage
* cardiac tamponade
* haemothorax
* intracranial haemorrhage
* gangrene and loss of digits.
These complications can arise due to severe coagulopathy.
Fill in the blank: DIC can be triggered by _______.
infections or severe underlying pathologies.
