Question

A 60-year-old woman presents with urosepsis, hematuria, petechiae, and mucosal bleeding. She has a hemoglobin of $12 \mathrm{~g} / \mathrm{dL}$, an elevated prothrombin time, a platelet pressors, antibiotics, and fresh frozen plasma are being administered. What other treatment modality is indicated next? (A) Platelet transfusion. (B) Packed red blood cell transfusion. (C) Cryoprecipitate. (D) Heparin.

   A 60-year-old woman presents with urosepsis, hematuria, petechiae, and mucosal bleeding. She has a hemoglobin of $12 \mathrm{~g} / \mathrm{dL}$, an elevated prothrombin time, a platelet pressors, antibiotics, and fresh frozen plasma are being administered. What other treatment modality is indicated next?
(A) Platelet transfusion.
(B) Packed red blood cell transfusion.
(C) Cryoprecipitate.
(D) Heparin.

Emergency Medicine Examination & Board Review

Susan Promes 3rd Edition

Chapter 11, Problem 12

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A 60-year-old woman presents with urosepsis, hematuria, petechiae, and mucosal bleeding. She has a hemoglobin of $12 \mathrm{~g} / \mathrm{dL}$, an elevated prothrombin time, a platelet pressors, antibiotics, and fresh frozen plasma are being administered. What other treatment modality is indicated next? (A) Platelet transfusion. (B) Packed red blood cell transfusion. (C) Cryoprecipitate. (D) Heparin.

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Key Concepts

Disseminated Intravascular Coagulation (DIC)

DIC is a complex clinical syndrome characterized by widespread activation of the clotting pathways leading to formation of microthrombi, consumption of platelets and clotting factors, and subsequent bleeding. It is commonly triggered by conditions such as sepsis, trauma, malignancy, or obstetric complications, and involves both thrombosis and hemorrhage, necessitating an approach that balances supportive care with targeted therapeutic interventions.

Heparin Therapy

Heparin is an anticoagulant that can be used in the management of DIC to inhibit the formation of microthrombi and prevent further consumption of clotting factors. Its use, particularly in cases where thrombosis predominates or when non-overt bleeding complications are controlled, is aimed at mitigating the prothrombotic component of DIC while treating the underlying cause of the disorder.

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