Disseminated Intravascular Coagulation (DIC) Flashcards Preview

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Flashcards in Disseminated Intravascular Coagulation (DIC) Deck (8)
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What are the types of DIC?

- Acute overt form: bleeding and depletion of platelets and clotting factors
- Chronic non-overt form: thromboembolism is accompanied by general activation of coagulation system


what are the risk factors for DIC?

- infection (gram -ve sepsis)
- obstetric complications (missed miscarriage, placental abruption, severe pre-eclampsia, amniotic emboli)
- malignancy (acute = acute promyelocytic leukaemia, chronic = lung, breast, GI malignancy)
- severe trauma or surgery


what is the pathophysiology of acute DIC?

- simultaneous activation of clotting cascade and fibrinolysis system
- depletion of substances/ factors
- massive bleeding in SC tissues, skin and mucous membranes
- occlusion of blood vessels by fibrin = microangiopathic HA and ischaemic organ damage


what is the pathophysiology of chronic DIC?

- identical to acute DIC but at a slower rate with compensatory responses
- compensation diminishes likelihood of overt bleeding
- but leads to hypercoagulable state
- thrombosis can occur


what is the presentation of DIC in general?

- fever, severely ill, evidence of shock


what is the presentation of acute DIC?

- petechiae
- purpura
- ecchymosis
- epistaxis
- mucosal bleeding
- overt haemorrhages
- end organ failure
- respiratory distress
- oliguria (2nd to renal failure)


what is the presentation of chronic DIC?

- DVT or arterial emboli/thrombi
- superficial venous thrombosis


what are the investigations?

- bloods: high d-dimers, high fibrin degradation products
- blood film: Schistocytes