The Fibrinolytic System: DIC (Part 2)

Question 0

What are six coag components consumed in clotting?

Answer 0

II, I, V, VIII, XIII, and platelets

Question 1

What is the consequence of uncontrolled formation and deposition of fibrin?

Answer 1

Leads to thromboses

Question 2

What is the consequence of the secondary activation of the fibrinolytic system?

Answer 2

Leads to bleeding

Question 3

What five coagulation components are digested by plasmin?

Answer 3

I, V, VIII, XIII, and fibrin

Question 4

What is the clinical presentation of DIC?

Answer 4

Multiple site bleeding, epistaxis, hematuria, oozing from intravascular sites, petechiae/purpura, and renal failure (due to free HGB)

Question 5

What is the treatment for DIC?

Answer 5

treat underlying condition, FFP and/or platelet transfusions, heparin thearapy, and antifibrinolytic therapy (AMICAR)

Question 6

Results of CBC with DIC?

Answer 6

schistocytes and decreased platelets

Question 7

Results of a PT and APTT in DIC?

Answer 7

Prolonged PT and APTT

Question 8

Results of a Fibrinogen in DIC?

Answer 8

Decreased

Question 9

Results of a platelet count in DIC?

Answer 9

Decreased count

Question 10

What are the 4 confirmatory tests for DIC?

Answer 10

TCT, Reptilase Test, FDP/FSP, D-Dimer

Question 11

What are the results of a TCT in DIC?

Answer 11

Prolonged because it takes longer for fibrinogen to form a fibrin clot

Question 12

Results of a reptilase time in DIC?

Answer 12

Prolonged, adding reptilase instead of thrombin to plasma

Question 13

Results of FDP/FSP in DIC?

Answer 13

Positive; more split products and acts as an anti thrombin

Question 14

Results for D-Dimer in DIC?

Answer 14

Positive; fibrinogen is influenced by XIII and DD’s are left over

Question 15

What are three conditions in which primary fibrinolysis may occur?

Answer 15

Open heart surgery, metastatic prostate cancer, and lightening strike patients

Question 16

Blood smear
1 DIC
2 primary fibrinolysis

Answer 16

1 schistos

2 no schistos

Question 17

D-Dimer
1 DIC
2 primary fibrinolysis

Answer 17

1 positive

2 negative

Question 18

Platelet count
1 DIC
2 primary fibrinolysis

Answer 18

1 decreased-consumed in clotting

2 normal

Question 19

Blood smear
1 DIC
2 TTP

Answer 19

1 schistos

2 schistos

Question 20

D-Dimer
1 DIC
2 TTP

Answer 20

1 positive

2 negative

Question 21

Platelet count
1 DIC
2 TTP

Answer 21

1 decreased

2 decreased

Question 22

PT
1 DIC
2 TTP

Answer 22

1 prolonged

2 usually normal

Question 23

APTT
1 DIC
2 TTP

Answer 23

1 prolonged

2 usually normal

Question 24

In TTP microthrombi are deposited through the body in microcirculation composed primarily of _______ , not fibrin like in DIC. This is PRIMARY hemostasis.

Answer 24

Platelets