Disseminated Intravascular coagulation

Question 1

Define Disseminated intravascular coagulation

Answer 1

ACQUIRED Systemic widespread activation of coagulation cascade-consume clotting factors and platelets-become very sensitive to bleeding

and intravascular thrombi

fibrin can also fill in small vessels and heamolyse RBC

can be acute or chronic-acute more common

Question 2

Aetiology and risk factors Disseminated intravascular coagulation

Answer 2

Usually relies on cascading thrombin activation, and impaired anti-thrombin pathway
Potentiation of coagulation via inflammation pathway

often causes are systemic disease: sepsis, malignancies, Obsetrics (eclampsia, dead fetus syndrome), severe organ failure, Toxic reaction (blood IV reaction, organ transplant, snake bite)

risk factors are those conditions

Question 3

Epidemology of Disseminated intravascular coagulation

Answer 3

Incidence is hard to determine but mortality is high. probably not reducing in incidence

Question 4

Symptoms and signs of Disseminated intravascular coagulation

Answer 4

The main one is the presence of underlying disorder

Oligouria/renal failure
Hypotension, tachycardia (shock, systemic failure)
Purpura Fulminans (rapid darkening/purple of skin -sepsis
Gangrene, cyanosis-thrombosis
Coma, confusion-thrombosis and/or inflammation

Petichiae (small dark dots)
Bruising/bleeding everywhere (when venipuncture)
Heamatouria (renal fail)-

Question 5

Investigations of Disseminated intravascular coagulation

Answer 5

Thrombocytopenia,
PT and APTT high,
Film-schistocytes
Fibrinogen down

D-dimer up
can measure the factors directly too (LOW)

usually 1 condition that causes it + weird coagulation results/signs should be enough