Question

A 50-year-old patient is transferred to the critical care unit from the emergency department. A rattlesnake bit him approximately 6 hours ago. He is having a severe reaction to the venom, and antivenom is being flown to the hospital. The patient is bleeding from his IV insertion sites and continues to seep blood from the wound. Which of the following diagnostic panels is suggestive of disseminated intravascular coagulation (DIC)?

A. Decreased platelets, decreased fibrinogen, prolonged prothrombin time (PT), prolonged activated partial thromboplastin time (aPTT), prolonged thrombin time, increased fibrin degradation products (FDPs)
B. Increased platelets, increased fibrinogen, normal PT, aPTT, normal thrombin time, increased fibrin degradation products (FDPs)
C. Increased platelets, decreased fibrinogen, prolonged PT, aPTT, prolonged thrombin time, decreased fibrin degradation products (FDPs)
D. Decreased platelets, increased fibrinogen, normal PT, aPTT, normal thrombin time, increased fibrin degradation products (FDPs)

Answer 1

The diagnostic panel suggestive of disseminated intravascular coagulation (DIC) shows decreased platelets, decreased fibrinogen, prolonged clotting times, and increased fibrin degradation products.

Step-by-step explanation:

The appropriate diagnostic panel suggestive of disseminated intravascular coagulation (DIC) for a patient with a severe reaction to rattlesnake venom is:
A. Decreased platelets, decreased fibrinogen, prolonged prothrombin time (PT), prolonged activated partial thromboplastin time (aPTT), prolonged thrombin time, increased fibrin degradation products (FDPs).

This panel reflects the consumption of clotting factors and platelets that occur in DIC, leading to uncontrolled bleeding. The decreased levels of platelets (thrombocytopenia) and fibrinogen, along with the prolongation of PT, aPTT, and thrombin time, indicate a widespread activation of the clotting cascade that depletes clotting factors and inhibits the formation of stable clots. The increased FDPs imply that fibrin is being actively broken down.