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HEM 302 > Haemostasis IV: Acquired Coagulation Disorders > Flashcards

Haemostasis IV: Acquired Coagulation Disorders Flashcards

1
Q

What is the definition of DIC?

A

DIC is defined as the reduction in circulating clotting factors due to intravascular thrombosis initiated by various events.

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2
Q

What initiates intravascular thrombosis in DIC?

A

Intravascular thrombosis in DIC is initiated by events such as surgical trauma, obstetric complications, acute haemolytic episodes, and malignancies.

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3
Q

What is the role of tissue thromboplastin in DIC?

A

Tissue thromboplastin releases, leading to the activation of the extrinsic system in DIC.

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4
Q

What events can activate the extrinsic system in DIC?

A

The extrinsic system in DIC can be activated by surgical trauma, obstetric complications, acute haemolytic episodes, and malignancies.

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5
Q

How does severe endothelial damage contribute to DIC?

A

Severe endothelial damage activates the intrinsic system in DIC.

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6
Q

What can directly induce platelet aggregation in DIC?

A

Direct induction of platelet aggregation in DIC can occur due to septicaemia.

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7
Q

What is the consequence of secondary activation of fibrinolysis in DIC?

A

Secondary activation of fibrinolysis in DIC results in the production of fibrin degradation products (FDP).

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8
Q

What are the haematological findings in DIC?

A

Haematological findings in DIC include thrombocytopenia, red cell fragments on blood film, prolonged bleeding time, PT, and PTT, decreased fibrinogen, factor V and VIII, and the presence of FDP.

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9
Q

What are the common causes of DIC?

A

Common causes of DIC include obstetric accidents, massive surgery, haemolytic transfusion reaction, septicaemia, snake bites, severe hypersensitivity reactions, disseminated cancer, acute promyelocytic leukaemia, and liver disease.

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10
Q

What obstetric complications can lead to DIC?

A

Obstetric complications that can lead to DIC include abruptio placenta, amniotic fluid embolism, eclampsia, and intrauterine death (IUD).

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11
Q

How can massive surgery contribute to DIC?

A

Massive surgery can contribute to the development of DIC.

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12
Q

What types of infections are associated with DIC?

A

Infections associated with DIC include septicaemia, particularly gram-negative and meningococcal infections.

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13
Q

What are the clinical forms of DIC?

A

The clinical forms of DIC are compensated, chronic or subacute, and acute.

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14
Q

What are the characteristics of compensated DIC?

A

Compensated DIC shows no symptoms and is only demonstrated in the laboratory.

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15
Q

What symptoms are associated with chronic or subacute DIC?

A

Chronic or subacute DIC may present with occasional mild symptoms like bruises and progressive organ failure.

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16
Q

What symptoms and signs are typically seen in acute DIC?

A

Acute DIC presents with widespread bruising and bleeding.

17
Q

What are the major symptoms due to DIC itself?

A

Major symptoms due to DIC itself include bleeding, organ damage due to ischemia (e.g., renal or adrenal failure), and microangiopathic haemolytic anaemia.

18
Q

How is compensated DIC diagnosed?

A

Compensated DIC is diagnosed using tests that detect platelet activation, such as P/F factor and thromboxane A2, and tests showing increased coagulation factor activation and thrombin generation, like elevated fibrinopeptide A and decreased levels of antithrombin III and protein C.

19
Q

What lab tests are used to diagnose DIC?

A

Lab tests for diagnosing DIC include PT, PTT, TT, platelet count, fibrinogen concentration, FDP concentration, and euglobulin lysis time.

20
Q

What are the lab findings in acute DIC?

A

In acute DIC, PT, PTT, TT are markedly prolonged, platelet count is decreased, fibrinogen concentration is decreased, FDP concentration is increased, and euglobulin lysis time is normal or short.

21
Q

What are the lab findings in subacute DIC?

A

In subacute DIC, PT, PTT, and TT are prolonged, platelet count is normal or slightly decreased, fibrinogen concentration is increased, and FDP concentration is normal or increased.

22
Q

What are the lab findings in chronic DIC?

A

In chronic DIC, PT, PTT, TT, platelet count, fibrinogen concentration, and FDP concentration can be normal, decreased, or increased.

23
Q

What are the principles of treating DIC?

A

The principles of treating DIC include eliminating the primary cause, replacing coagulation factors and platelets, and inhibiting the clotting process with heparin or other agents.

24
Q

What general support measures are used in the treatment of acute DIC?

A

General support measures in the treatment of acute DIC include fluids, blood, respiratory care, and antibiotics.

25
Q

What coagulation factors and components are replaced in the treatment of DIC?

A

In the treatment of DIC, coagulation factors and components replaced include fresh frozen plasma (FFP), cryoprecipitate, and platelets.

26
Q

How is the clotting process inhibited in the treatment of DIC?

A

The clotting process in DIC is inhibited using heparin or other agents.

27
Q

Why is bleeding associated with liver disease?

A

Bleeding associated with liver disease occurs due to renal failure, abnormal endothelial function, reduced platelet production, and acquired platelet dysfunction.

28
Q

What renal complication develops in end-stage liver disease?

A

Renal failure develops in end-stage liver disease.

29
Q

How does abnormal endothelial function contribute to bleeding in liver disease?

A

Abnormal endothelial function contributes to bleeding in liver disease by impairing vascular integrity.

30
Q

How does reduced platelet production occur in liver disease?

A

Reduced platelet production in liver disease occurs due to decreased thrombopoietin.

31
Q

What causes acquired platelet dysfunction in liver disease?

A

Acquired platelet dysfunction in liver disease is caused by factors such as uremia and hepatic dysfunction.

HEM 302 (5 decks)

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