Disseminated Intravascular Coagulation
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Thomas G. DeLoughery, MD, MACP, FAWM
Professor of Medicine, Oregon Health & Science University, Portland, OR

Question 1 of 5

A 35-year-old woman presents with increased bruising. On exam, she is noted to have extensive ecchymosis. Laboratory testing shows a markedly elevated international normalized ratio (INR) and activated partial thromboplastin time (aPTT), platelet count of 15,000/µL, and a fibrinogen level of 35 mg/dL. The hematocrit is low at 21% and the total white blood cell count is only 2000 cells/µL. Rare blasts are noted on the blood smear.

What is the next step in the management of this patient?

Limit blood products to avoid perpetuating the cycle of thrombosis

Order fluorescence in situ hybridization (FISH) testing for the 15;17 translocation before starting antileukemia therapy

Start chemotherapy with 7+3 regimen (7 days of cytarabine plus 3 days of an anthracycline antibiotic)

Start all-trans retinoic acid (ATRA) therapy

Start arsenic therapy

Hospital Physician: Hematology/Oncology. 2017 September;12(5)

This quiz is not accredited for CME.

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