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

Explanation

## 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