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11 Cards in this Set
- Front
- Back
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What is Disseminated Intravascular Coagulation (DIC)?
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- DIC is a response to an injury that causes activation of NORMAL blood clotting and fibrinolytic mechanisms
- stimulus for activation is so robust that it overwhelms the normal control mechanisms that usually limit clotting and fibrinolysis to the areas where they may actually be needed |
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What are 5 conditions associated with DIC?
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1. Tissue Damage
2. Neoplasia (cancer/tumor) 3. Miscellaneous (shock, cardiac arrest) 4. Microorganisms 5. Obstetric Conditions |
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What is the mechanism of DIC?
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- Occurs when there is a stimulus for coagulation that is not controlled
- Initiated by exposure of the blood to Tissue Factor (TF) - TF induces coagulation and then later fibrinolysis - Clotting and inhibitory factors are eventually consumed at greater rates than they can be produced |
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What are the clinical manifestations of DIC?
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Can be bleeding, thrombosis, or both
Acutely ill patient = bleed Cancer = thrombosis |
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What are the laboratory findings of DIC?
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- Increased PT and aPTT (bc clotting factors are consumed)
- Decreased platelet count (bc used up) - Schistocytes (RBC fragments) and thrombocytopenia - Presence of D-Dimers |
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What do the presence of D-Dimers indicate?
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- D-Dimers are the XIII-crosslinked fragments of polymerized fibrin
- Therefore, if seen D-Dimers signify that clotting must have occured - Can help diagnose DIC and also see if there is a clot |
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What is the treatment for DIC?
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Treat the underlying cause (ex: infection, aneurysm, cancer, etc)
If bleeding, support with replacement of clotting factors, fibrinogen, and platelet transfusion - In some (RARE) cases of cancer induced chronic DIC, heparin is used to inhibit coagulation |
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What are lupus anticoagulants?
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A heterogeneous group of antibodies
- some bind to phospholipids - some bind to phospholipid-associated proteins |
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What is the effect that lupus anticoagulants have in-vitro with an aPTT?
Is there an effect in vivo? |
Prolonged aPPT because bind to limited phospholipids
Usually NO EFFECT in vivo (but are a risk factor for thrombosis) |
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What defines Antiphospholipid antibody syndrome?
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1. Presence of one or more types of antiphospholipid antibodies on at least 2 occasions 3 months apart and...
2. Thrombosis 3. Pregnancy Morbidity |
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What is the treatment for antiphospholipid antibody syndrome?
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Anticoagulants as prophylaxis (or Tx) from thrombosis
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