Disseminated intravascular coagulation physical examination: Difference between revisions

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==Overview==
==Overview==
Common physical examination findings of [[DIC]] include signs of spontaneous and life-threatening [[hemorrhage]], signs of subacute [[bleeding]], signs of diffuse or localized [[thrombosis]], [[bleeding]] into [[serous]] cavities, nonspecific altered [[consciousness]] or [[stupor]], transient focal [[Neurological|neurologic]] deficits, [[hypotension]], [[tachycardia]], circulatory collapse, [[pleural friction rub]], signs of [[acute respiratory distress syndrome]] (ARDS), [[hematemesis]], [[hematochezia]], signs of [[azotemia]] and [[renal failure]], [[acidosis]], [[hematuria]], [[oliguria]], [[metrorrhagia]] and [[uterine hemorrhage]].
==Physical Examination==
Physical examination of patients with [[DIC]] is usually remarkable for the following:<ref name="pmid29021432">{{cite journal |vauthors=Miyashima Y, Iwamuro M, Shibata M, Miyabe Y, Kawai Y, Kaihara M, Mitogawa T, Harada M |title=Prediction of Disseminated Intravascular Coagulation by Liver Function Tests in Patients with Japanese Spotted Fever |journal=Intern. Med. |volume=57 |issue=2 |pages=197–202 |date=January 2018 |pmid=29021432 |pmc=5820036 |doi=10.2169/internalmedicine.8420-16 |url=}}</ref><ref name="pmid30198317">{{cite journal |vauthors=Iba T, Arakawa M, Ohchi Y, Arai T, Sato K, Wada H, Levy JH |title=Prediction of Early Death in Patients With Sepsis-Associated Coagulation Disorder Treated With Antithrombin Supplementation |journal=Clin. Appl. Thromb. Hemost. |volume= |issue= |pages=1076029618797474 |date=September 2018 |pmid=30198317 |doi=10.1177/1076029618797474 |url=}}</ref><ref name="pmid30189766">{{cite journal |vauthors=Kilicci C, Ozkaya E, Karakus R, Sanverdi I, Abide Yayla C, Bostanci Ergen E, Mutlu S |title=Early low molecular weight heparin for postpartum hemorrhage in women with pre-eclampsia. Is it effective to prevent consumptive coagulopathy? |journal=J. Matern. Fetal. Neonatal. Med. |volume= |issue= |pages=1–5 |date=September 2018 |pmid=30189766 |doi=10.1080/14767058.2018.1494708 |url=}}</ref><ref name="pmid30185500">{{cite journal |vauthors=McBride AM |title=Clinical Presentation and Treatment of Amniotic Fluid Embolism |journal=AACN Adv Crit Care |volume=29 |issue=3 |pages=336–342 |date=2018 |pmid=30185500 |doi=10.4037/aacnacc2018419 |url=}}</ref><ref name="pmid30184540">{{cite journal |vauthors=Judkins AJ, MacQueen BC, Christensen RD, Henry E, Snow GL, Bennett ST |title=Automated Quantification of Fragmented Red Blood Cells: Neonatal Reference Intervals and Clinical Disorders of Neonatal Intensive Care Unit Patients with High Values |journal=Neonatology |volume=115 |issue=1 |pages=5–12 |date=September 2018 |pmid=30184540 |doi=10.1159/000491626 |url=}}</ref>
=== Hemtological: ===
* Signs of spontaneous and life-threatening [[hemorrhage]]
* Signs of subacute [[bleeding]]
* Signs of diffuse or localized [[thrombosis]]
* Bleeding into [[serous]] cavities


==Physical examination==
=== Nervous: ===
*:* More specific signs include petechiae, purpura, hemorrhagic bullae, acral cyanosis and occasionally frank gangrene.
* Nonspecific altered [[consciousness]] or [[stupor]]
*:* Microvascular thrombi are most often seen in the cardiac, pulmonary, renal, hepatic and CNS (central nervous system) circulation.
* Transient focal [[Neurological|neurologic]] deficits


=== Cardiovascular: ===
* [[Hypotension]]
* [[Tachycardia]]
* [[Circulatory]] collapse
=== Respiratory: ===
* [[Pleural friction rub]]
* Signs of [[acute respiratory distress syndrome]] (ARDS)
=== Gastrointestinal: ===
* [[Hematemesis]]
* [[Hematochezia]]
=== Genitourinary: ===
* Signs of [[azotemia]] and [[renal failure]]
* [[Acidosis]]
* [[Hematuria]]
* [[Oliguria]]
* [[Metrorrhagia]]
* [[Uterine hemorrhage]]
=== Skin: ===
* [[Petechiae]]
* [[Jaundice]] (liver dysfunction or hemolysis)
* [[Purpura]]
* [[Hemorrhagic]] bullae
* Acral [[cyanosis]]
* Skin [[necrosis]] of lower limbs ([[purpura fulminans]])
* Localized [[infarction]] and [[gangrene]]
* Wound [[bleeding]] and deep subcutaneous hematomas
* [[Thrombosis]]


==References==
==References==
{{reflist|2}}
[[Category:Hematology]]
[[Category:Cardiology]]


{{reflist|2}}
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Latest revision as of 16:22, 19 September 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omer Kamal, M.D.[2]

Overview

Common physical examination findings of DIC include signs of spontaneous and life-threatening hemorrhage, signs of subacute bleeding, signs of diffuse or localized thrombosis, bleeding into serous cavities, nonspecific altered consciousness or stupor, transient focal neurologic deficits, hypotension, tachycardia, circulatory collapse, pleural friction rub, signs of acute respiratory distress syndrome (ARDS), hematemesis, hematochezia, signs of azotemia and renal failure, acidosis, hematuria, oliguria, metrorrhagia and uterine hemorrhage.

Physical Examination

Physical examination of patients with DIC is usually remarkable for the following:[1][2][3][4][5]

Hemtological:

Nervous:

Cardiovascular:

Respiratory:

Gastrointestinal:

Genitourinary:

Skin:

References

  1. ↑ Miyashima Y, Iwamuro M, Shibata M, Miyabe Y, Kawai Y, Kaihara M, Mitogawa T, Harada M (January 2018). "Prediction of Disseminated Intravascular Coagulation by Liver Function Tests in Patients with Japanese Spotted Fever". Intern. Med. 57 (2): 197–202. doi:10.2169/internalmedicine.8420-16. PMC 5820036. PMID 29021432.
  2. ↑ Iba T, Arakawa M, Ohchi Y, Arai T, Sato K, Wada H, Levy JH (September 2018). "Prediction of Early Death in Patients With Sepsis-Associated Coagulation Disorder Treated With Antithrombin Supplementation". Clin. Appl. Thromb. Hemost.: 1076029618797474. doi:10.1177/1076029618797474. PMID 30198317.
  3. ↑ Kilicci C, Ozkaya E, Karakus R, Sanverdi I, Abide Yayla C, Bostanci Ergen E, Mutlu S (September 2018). "Early low molecular weight heparin for postpartum hemorrhage in women with pre-eclampsia. Is it effective to prevent consumptive coagulopathy?". J. Matern. Fetal. Neonatal. Med.: 1–5. doi:10.1080/14767058.2018.1494708. PMID 30189766.
  4. ↑ McBride AM (2018). "Clinical Presentation and Treatment of Amniotic Fluid Embolism". AACN Adv Crit Care. 29 (3): 336–342. doi:10.4037/aacnacc2018419. PMID 30185500.
  5. ↑ Judkins AJ, MacQueen BC, Christensen RD, Henry E, Snow GL, Bennett ST (September 2018). "Automated Quantification of Fragmented Red Blood Cells: Neonatal Reference Intervals and Clinical Disorders of Neonatal Intensive Care Unit Patients with High Values". Neonatology. 115 (1): 5–12. doi:10.1159/000491626. PMID 30184540.


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