Which of the following is not a feature of DIC?
Ans: d (Platelet function defect) Ref: Harrison's, 16th ed, p. 684,17th ed, p. 729Platelet function defect is not usually a feature of DIC.DICIt is caused by activation of coagulation (thrombotic phase) by both intrinsic and extrinsic mechanisms.When most coagulation factors and platelets are consumed (consumption phase), both the bleeding time and coagulation time are prolonged.PT - increasedPTT- increasedThrombin time: increasedIncreased secondary fibrinolysis results in raised plasmin levels leading to raised levels of fibrin degradation products(FDP)Features of microangiopathic hemolytic anaemia is due to increased destruction of RBC - resulting in presence of schistocytes, spherocytes. burr cells, helmet cells in peripheral blood smear.Rx1) Most important is the treatment of cause2) Control the major symptom - either bleeding or thrombosis3) Prevent the recurrence of DICNOTE:- The most common causes of DIC are bacterial sepsis, malignant disorders such as solid tumours or acute promyelocytic leukaemia (APL), and obstetric causes.- The most sensitive test for DIC is the FDP level- Finding in DIC, that correlates best and more closely with bleeding is fibrinogen level- Most common site for thrombi formation in DIC: Brain > Heart > Lung- 2 endocrine manifestations of DICa) Waterhouse- Friderichsen syndrome - adrenalsb) Sheehan's syndrome - pituitaryIn thrombotic thrombocytopenic purpura -- all tests of coagulation are normalNormal PTNormal aPTTNormal fibrinogen concentrat ionNormal fibrin degradation products
Prolonged PT and aPTT
Increased fibrin degradation products
Thrombocytopenia
Platelet function defect
Blood