Tuesday, April 8, 2014

DIC (Disseminated Intravascular Coagulopathy)

Causes: 

Gram Negative Sepsis (E. Coli and Neisseria)
Rocky Mountain Spotted Fever
Malaria
AML
Pancreatic Ca
Crush Injuries
Rattlesnake Bite
Amniotic Fluid Embolism
Abrutio Placenta

Pathology

Activation of coagulation cascade by Tissue Thromboplastin: Consumption of Clotting Factors
Platelet clot formation: Reduced Platelets
Microclots in circulation: Fibrinogen
Hemolysis of RBCs: Anemia
Clot lysis: FDPs and D Dimer

Petechiae and bruises
Bleeding from all orifices

Laboratory:

Increased PT and APTT (Consumtion of Coagulants)
Reduced RBC and Platelets counts
Schistocytes
Increased FDPs and D Dimer
Reduced Fibrinogen

Treatment:

Treat the Cause
Transfuse FFP, Platelets, RBCs, Cryo

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