Disseminated Intravascular Coagulation (DIC) Flashcards
What is DIC.
Pathological activation of coagulation resulting in bleeding and widespread microvascular thrombosis.
Involves the release of pro-coagulants into the circulation and the consumption of clotting factors and platelets.
What are the causes of DIC. (8)
Infection (sepsis, gram negative). Malignancy. Obstetric (delivery complications). Immunological. Severe liver disease. Haemolytic transfusion reactions. Toxic (snake bites, recreational drugs). Tissue destruction (burns, surgery, pancreatitis).
What are some infective causes of DIC. (3)
Gram negative bacteria.
Meningococcal.
Viral.
What are some malignant causes of DIC. (2)
Sold tumours (prostate, pancreas, lung, stomach). Leukaemia.
What are some obstetric causes of DIC. (3)
Pre-eclampsia.
Placenta abruption.
Amniotic fluid embolus.
What is an immunological cause of DIC.
Anaphylaxis.
What is a liver disease cause of DIC. (2)
Acute liver disease.
Cirrhosis.
What are the symptoms of DIC. (5)
Haemorrhage (anywhere, eg venepuncture site, mouth, nose). Widespread microthrombi. Large vessel thrombosis. Haemorrhagic tissue necrosis. Renal failure.
What are the blood results of a patient with DIC. (6)
Raised PT. Raised APTT. Raised TT. Decreased fibrinogen. Decreased platelets. Raised fibrin degradation products (FDP).
What is the role of Fibrin in DIC.
Fibrin strands fill the small vessels, haemolysing passing RBCs.
Fibrinolysis is also activated.
What is seen on a blood film in DIC.
Schistocytes (broken RBCs).
What are the two main features of DIC. (2)
Diffuse endothelial damage.
Generalized platelet aggregation.
This leads to a mixture of initial thrombosis followed by a bleeding tendency due to consumption of coagulation factors and fibrinolytic activation.
What organs tend to be most affected in DIC thrombotic events. (3)
Skin.
Brain.
Kidneys.
What two factors are usually used in DIC. (2)
Factors V and VIII.
What scoring system is used to diagnose DIC.
ISTH scoring system.
