Haem: Disseminated Intravascular Coagulation: Free MSRA Podcast

🎧 Disseminated Intravascular Coagulation (DIC) – MSRA Deep Dive 🩸⚖️In this high-yield episode, we unpack the chaotic and critical world of DIC – a classic MSRA buzzword and a must-know emergency in clinical practice. Whether it’s sepsis, trauma, or obstetric complications, DIC is always secondary – and always serious.🔍 What You’ll Learn:• Definition: – DIC = a dangerous imbalance where the body clots and bleeds at the same time – Triggered by systemic activation of the coagulation cascade 🧬• Causes – Use the Mnemonic STUMPLOTS: – Sepsis – Trauma – Uncommon (e.g. Snakebite 🐍) – Malignancy – Pregnancy (e.g. placental abruption, amniotic fluid embolism) – Liver failure – Overlooked transfusion reactions – Therapies (certain drugs)• Pathophysiology: – Widespread clot formation due to massive thrombin activation – Consumption of platelets & clotting factors → bleeding risk – Simultaneous fibrinolysis worsens the bleeding🩺 Clinical Features:• Acute DIC: – Bleeding from ≥3 unrelated sites (e.g. gums, IV lines, hematuria) – Bruising, petechiae, purpura, oozing, hematuria – Confusion, respiratory distress, multi-organ failure – Skin signs: hemorrhagic bullae, acrocyanosis, gangrene• Chronic DIC: – Often more thrombotic than bleeding – Presents with DVT, PE, subtle clot-related signs – Common in malignancy (especially haematological)🧪 Investigations:• 🧬 CBC – ↓ Platelets• 🧬 Coagulation profile – ↑ PT, ↑ APTT• 🧬 Fibrinogen – ↓ (but can be normal in early or chronic cases)• 🧬 D-dimer – ↑↑ (very high)• 🧬 ISTH DIC Score – Helps quantify severity and diagnose overt DIC📈 Note: Also consider causes of thrombocytopenia and clotting disorders like TTP, HUS, APL, viral hemorrhagic fevers.🧰 Management Strategy:🚨 Treat the underlying cause – always the priority (e.g. antibiotics for sepsis, surgery for trauma)💧 Supportive care – fluids, monitor organ function🩸 Blood products if bleeding or before surgery: – Platelets if bleeding + <50 – FFP for prolonged PT/APTT – Cryoprecipitate or fibrinogen concentrate if fibrinogen <1–1.5 g/L⚖️ Heparin – sometimes used if thrombosis dominates in chronic DIC❌ Avoid antifibrinolytics (e.g. tranexamic acid) in most DIC cases unless extremely selective circumstances📉 Prognosis:• Depends on: – Speed of intervention – Severity of underlying trigger – Extent of organ damage• Complications: – Multi-organ failure – Catastrophic bleeding – Ischemic tissue damage (e.g. limb loss from thrombosis)💬 Recovery is possible with early recognition + targeted management, but DIC remains a red flag in any critical care setting.🧠 Memory Aids for the Exam:• 🔠 STUMPLOTS – for DIC triggers• 📊 Low platelets + High PT/APTT + High D-dimer + Low fibrinogen = DIC• 🧪 ISTH Scoring helps standardise diagnosis• ⚖️ Treat cause first, then correct coagulation imbalances📝 Revision Resources:• 📘 Revision Notes:https://www.passthemsra.com/topic/disseminated-intravascular-coagulation-revision-notes/• 🃏 Flashcards:https://www.passthemsra.com/topic/disseminated-intravascular-coagulation-flashcards/• 📂 Accordion Q&A Notes:https://www.passthemsra.com/topic/disseminated-intravascular-coagulation-accordion-qa-notes/• 🎯 Rapid Fire Quiz:https://www.passthemsra.com/topic/disseminated-intravascular-coagulation-rapid-quiz/• 🧪 Practice Quiz:https://www.passthemsra.com/quizzes/disseminated-intravascular-coagulation/🌐 Main Sites:https://www.passthemsra.comhttps://www.freemsra.com🤔 Final Thought:DIC is the canary in the coal mine. It’s a signal that the body is overwhelmed – a reaction, not a diagnosis. Spotting it early can mean the difference between life and death. Are we doing enough to identify it in time across busy wards and ICUs?#MSRA #DIC #DisseminatedIntravascularCoagulation #MSRAHaematology #MSRAQuestionBank #MSRAFlashcards #MSRAAccordions #PassTheMSRA #FreeMSRA #AcuteMedicine #CriticalCare #UKMLA #MSRARevision