Tuesday, 21 September 2010

MRCP revision battle 17.1: DIC

Lots of short battles from a variety of specialities today so buckle up for a ride through some haematology, neurology, endocrinology, respiratory and dermatology.  Yeee-hhaaaa!

MRCP revision battle 17.1: DIC
MRCP revision battle 17.2: Jugular foramen syndrome
MRCP revision battle 17.3: Thyroid cancer
MRCP revision battle 17.4: Legionella infection
MRCP revision battle 17.5: Pleural calcification
MRCP revision battle 17.6: Pseudoxathoma elasticum

MRCP revision battle 17.1: DIC

Disseminated intravascular coagulation (=DIC) is the pathalogical widespread activation of coagulation.

Blood tests will show:
  • prolonged PT
  • prolonged aPTT
  • massively raised d-dimer levels
  • low platelets
  • low fibrinogen
  • schistocytes

Of these, it is the level of fibrinogen which best correlates to the severity.

Causes of DIC include:
  • obstetric
  • crush injury
  • septicaemia
  • malignancy
  • transfusion reaction

The treatment is:
  • treat the cause
  • give platelets if platelets <50
  • cryoprecipitate
  • FFP
  • activated protein C if septic.

Now lets canter onwards to jugular foramen syndrome....