A critically ill septic patient develops bleeding from venipuncture sites. Coagulation profile shows prolonged PT, prolonged PTT, thrombocytopenia, low fibrinogen, and elevated D-dimer. What is the diagnosis?

Answer and explanation

Correct answer: C. Disseminated intravascular coagulation

  1. Step 1: Systemic activation of coagulation in severe sepsis consumes platelets and clotting factors, leading to widespread microthrombosis and secondary fibrinolysis.
  2. Step 2: The diagnostic hallmark of disseminated intravascular coagulation (DIC) is consumptive coagulopathy characterized by prolonged PT and PTT, thrombocytopenia, hypofibrinogenemia, and markedly elevated D-dimer.
Answer
Disseminated intravascular coagulation.
Why not the others: Vitamin K deficiency causes prolonged PT and PTT but maintains normal platelet counts and normal fibrinogen levels. Hemophilia A is an X-linked deficiency of factor VIII characterized by isolated prolongation of PTT with normal PT, normal platelets, and normal fibrinogen. Antiphospholipid syndrome is a thrombophilic condition that prolongs PTT in vitro without causing consumptive hypofibrinogenemia.

Practise more Diagnostic Pathology and Therapeutics.

Free questions with an explanation for every one, and full timed DHA Dubai mock tests.

All Diagnostic Pathology and Therapeutics questionsTake a mock test

More Diagnostic Pathology and Therapeutics questions