Which of the following clinical manifestations of Disseminated intravascular coagulation (DIC)?
Decreased hematocrit, increased platelet counts, increased D-dimer
Decreased platelet counts, increased D-dimer, increased prothrombin time
Decreased Antithrombin III, increased platelet counts, increased fibrinogen
Decreased D-dimer, increased platelet counts, Increased hemoglobin
The Correct Answer is B
Disseminated Intravascular Coagulation (DIC) is a condition characterized by widespread activation of the coagulation system, leading to both excessive clot formation and consumption of clotting factors and platelets. This process can result in both bleeding and thrombosis.
The manifestations mentioned in option B are commonly seen in DIC:
Decreased platelet counts: DIC leads to platelet consumption and destruction, resulting in low platelet counts (thrombocytopenia).
Increased D-dimer: D-dimer is a fibrin degradation product, and its levels are increased DIC due to the breakdown of fibrin clots.
Increased prothrombin time (PT): DIC can lead to the depletion of clotting factors, resulting in prolonged prothrombin time, indicating impaired coagulation.
The other options mentioned do not represent the typical clinical manifestations of DIC:
A. Decreased hematocrit, increased platelet counts, and increased D-dimer in (option A) are incorrect because While platelet counts and D-dimer are increased in DIC, decreased hematocrit is not a characteristic finding.
C. Decreased Antithrombin III, increased platelet counts, and increased fibrinogen in (option C) is incorrect because: Decreased Antithrombin III can be seen in DIC, but increased platelet counts and fibrinogen levels are not specific to DIC.
D. Decreased D-dimer, increased platelet counts, and increased hemoglobin in (option D) is incorrect because Decreased D-dimer and increased hemoglobin are not typical findings in DIC, while increased platelet counts can be seen in some cases.
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Related Questions
Correct Answer is D
Explanation
Beck's triad consists of three classic clinical manifestations that are suggestive of cardiac tamponade, which is the compression of the heart by accumulated fluid or blood within the pericardial sac. The three components of Beck's triad include:
A. Muffled heart tones in (option A) are incorrect because Cardiac tamponade can dampen or muffle heart sounds due to the presence of fluid or blood around the heart, which can impair sound transmission.
B. Marked hypotension in (option B) is incorrect because Cardiac tamponade can cause decreased cardiac output, leading to hypotension, which is characterized by low blood pressure.
C. Distended jugular veins in (option C) is incorrect because Elevated venous pressure resulting from impaired filling and elevated right-sided heart pressures can lead to jugular vein distension, which is commonly seen in cardiac tamponade.
However, widening pulse pressure (the difference between systolic and diastolic blood pressure) is not typically part of Beck's triad. Widening pulse pressure is associated with her conditions such as aortic regurgitation, hyperthyroidism, or conditions involving increased stroke volume, rather than cardiac tamponade specifically.
Correct Answer is B
Explanation
Lactate is a by-product of anaerobic metabolism that accumulates when there is insufficient oxygen supply to meet cellular metabolic demands. In the context of severe tissue hypoxia, such as in septic shock, the body may resort to anaerobic metabolism, leading to increased lactate production and elevated lactate levels in the blood.
Elevated lactate levels, typically above 4.0 mmol/L, are indicative of tissue hypoxia and inadequate oxygenation at the cellular level. Higher lactate levels, such as 9.0 mmol/L, suggest more severe tissue hypoxia and increased anaerobic metabolism.
A. Partial thromboplastin time (PTT) 64 seconds in (option A) is incorrect because: PTT is a laboratory test that evaluates the intrinsic pathway of the coagulation cascade. While coagulation abnormalities may occur in septic shock, PTT alone does not specifically indicate severe tissue hypoxia.
C. Potassium 2.8 mEq/L (2.8 mmol/L) (option C) is incorrect because Low potassium levels (hypokalemia) can be a concern in septic shock, but it does not directly indicate severe tissue hypoxia.
D. PaCO2 58 mm Hg in (option D) is incorrect because: PaCO2 refers to the partial pressure of carbon dioxide in arterial blood and is a measure of the respiratory status. While an elevated PaCO2 can be a sign of respiratory acidosis, it is not specific to severe tissue hypoxia.
Therefore, in a critically ill patient with septic shock, an elevated lactate level, such as 9.0 mmol/L, indicates severe tissue hypoxia and inadequate oxygenation at the cellular level
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