The Fibrinolytic System: DIC (Part 2) Flashcards
What are six coag components consumed in clotting?
II, I, V, VIII, XIII, and platelets
What is the consequence of uncontrolled formation and deposition of fibrin?
Leads to thromboses
What is the consequence of the secondary activation of the fibrinolytic system?
Leads to bleeding
What five coagulation components are digested by plasmin?
I, V, VIII, XIII, and fibrin
What is the clinical presentation of DIC?
Multiple site bleeding, epistaxis, hematuria, oozing from intravascular sites, petechiae/purpura, and renal failure (due to free HGB)
What is the treatment for DIC?
treat underlying condition, FFP and/or platelet transfusions, heparin thearapy, and antifibrinolytic therapy (AMICAR)
Results of CBC with DIC?
schistocytes and decreased platelets
Results of a PT and APTT in DIC?
Prolonged PT and APTT
Results of a Fibrinogen in DIC?
Decreased
Results of a platelet count in DIC?
Decreased count
What are the 4 confirmatory tests for DIC?
TCT, Reptilase Test, FDP/FSP, D-Dimer
What are the results of a TCT in DIC?
Prolonged because it takes longer for fibrinogen to form a fibrin clot
Results of a reptilase time in DIC?
Prolonged, adding reptilase instead of thrombin to plasma
Results of FDP/FSP in DIC?
Positive; more split products and acts as an anti thrombin
Results for D-Dimer in DIC?
Positive; fibrinogen is influenced by XIII and DD’s are left over
What are three conditions in which primary fibrinolysis may occur?
Open heart surgery, metastatic prostate cancer, and lightening strike patients
Blood smear
1 DIC
2 primary fibrinolysis
1 schistos
2 no schistos
D-Dimer
1 DIC
2 primary fibrinolysis
1 positive
2 negative
Platelet count
1 DIC
2 primary fibrinolysis
1 decreased-consumed in clotting
2 normal
Blood smear
1 DIC
2 TTP
1 schistos
2 schistos
D-Dimer
1 DIC
2 TTP
1 positive
2 negative
Platelet count
1 DIC
2 TTP
1 decreased
2 decreased
PT
1 DIC
2 TTP
1 prolonged
2 usually normal
APTT
1 DIC
2 TTP
1 prolonged
2 usually normal
In TTP microthrombi are deposited through the body in microcirculation composed primarily of _______ , not fibrin like in DIC. This is PRIMARY hemostasis.
Platelets
