All of the following are characteristic laboratory findings in disseminated intravascular coagulation (DIC) EXCEPT:

Question

Accepted Answer

B. Elevated platelet count with normal fibrinogen levels. ## Laboratory Profile of DIC

**Key Point:** DIC is characterized by simultaneous activation of coagulation and fibrinolysis, resulting in a distinctive laboratory pattern of consumption coagulopathy.

### Correct Laboratory Findings in DIC

| Finding | Status in DIC | Mechanism |
|---------|---------------|----------|
| PT/aPTT | Prolonged | Consumption of clotting factors (II, V, VII, X, fibrinogen) |
| Platelet count | Decreased | Consumption in microthrombi formation |
| Fibrinogen | Decreased | Consumption and degradation |
| D-dimer | Markedly elevated | Excessive fibrin formation and degradation |
| FDP | Elevated | Plasmin-mediated fibrinolysis |
| Thrombin time | Prolonged | Low fibrinogen + elevated FDP |

### Why Option 3 is Wrong

**High-Yield:** Elevated platelet count with normal fibrinogen is **NOT** seen in DIC. This pattern would suggest either:
- A reactive thrombocytosis (infection, malignancy without DIC)
- Normal hemostasis

In DIC, **both platelet count and fibrinogen are consumed and therefore LOW**, not elevated or normal.

### DIC Scoring System (ISTH Criteria)

**Clinical Pearl:** The International Society on Thrombosis and Haemostasis (ISTH) scoring system incorporates:
1. Platelet count (decrease)
2. D-dimer/FDP elevation (increase)
3. PT prolongation
4. Fibrinogen level (decrease)

A score ≥5 is compatible with overt DIC in the appropriate clinical context.

**Mnemonic: COAGULOPATHY** — **C**onsumption of **O**f **A**ll **G**rowth **U**nits **L**eads **O**ver **P**athway **A**ctivation **T**o **H**emostatic **Y**failure

Answer

A. Prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT)

Answer

C. Elevated D-dimer and fibrin degradation products (FDP)

Answer

D. Decreased platelet count and hypofibrinogenemia

All of the following are characteristic laboratory findings in disseminated intravascular coagulation (DIC) EXCEPT:

Explanation

Laboratory Profile of DIC

Correct Laboratory Findings in DIC

Why Option 3 is Wrong

DIC Scoring System (ISTH Criteria)

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Finding	Status in DIC	Mechanism
PT/aPTT	Prolonged	Consumption of clotting factors (II, V, VII, X, fibrinogen)
Platelet count	Decreased	Consumption in microthrombi formation
Fibrinogen	Decreased	Consumption and degradation
D-dimer	Markedly elevated	Excessive fibrin formation and degradation
FDP	Elevated	Plasmin-mediated fibrinolysis
Thrombin time	Prolonged	Low fibrinogen + elevated FDP