Bleeding in DIC is most closely related to ?: (A) Raised fibrin degradation products level in blood, (B) Prolong prothrombin time, (C) Low serum fibrinogen level, (D) Raised thrombin time
Answer is C. Ans. is 'c' i.e., Low Serum fibrinogen level "In C fibrinogen is depleted" o DIC is a common acquired coagulation disorder resulting due to excessive activation of the coagulation system, usually due to massive tissue injury or sepsis. o The normal anticoagulants and fibrinolytic systems are overwhelmed and cannot contain the coagulation activation which becomes systemic, resulting in disseminated microvascular thrombi formation. o Platelets, coagulation factors and natural anticoagulants become depleted owing to thrombi formation. o The consumption of coagulation factors causes PT and PTT prolongations and may lead to bleeding. o Depletion of platelets may also contribute to the bleeding risk --) T BT. o The fibrinolytic system is activated to dissolve the fibrin thrombi, resulting in consumption of plasminogen from its conversion to plasmin and the formation of FDP's, including D-Dimers. FDP's can also contribute to bleeding because they impair fibrin clot formation and interfere with platelet function. Clinical Features of D.I.C. o In D.I.0 the most obvious clinical symptom is bleeding. There is abrupt onset of bleeding in the form of ecchymoses or petechiae. o Bleeding from sites of venipuncture. o Gum bleeding, epistaxis and gastrointestinal hemorrhage State of shock may develop. o Acute renal failure is not uncommon. Signs and symptoms of intracranial bleeding and pulmonary hemorrhage. o Clinical features of underlying disease.