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Old 08-24-2012
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Question @casandra...DIC question

can you take a look at option iic.
they wouldn't allow me post the link;

Disseminated Intravascular Coagulation

I. Physiology of Disseminated intravascular coagulation (DIC):
DIC is the syndrome that occurs when the clotting cascade goes awry. This is a clotting and bleeding disorder that results from the generation of tissue factor activity within the blood. This trigger of the coagulation cascade quickly leads to significant thrombin production which perpetuates its own formation. In very little time, the existing regulatory factors such as antithrombin III, protein C, and protein S are consumed. As a result, large amounts of thrombin are generated, leading to a hypercoagulable state. In the normal physiological state, plasmin is responsible for breaking fibrin into fibrin split products, thereby limiting the amount of fibrin clot being formed. In DIC, the quantity of plasmin is significantly increased, leading to the generation of significant quantities of fibrin degradation products. This often results in bleeding.
II. DIC usually occurs because of an underlying cause. It often arises in one of the following three clinical situations.
A. Complications of obstetrics where uterine material with tissue factor activity gains access to the maternal circulation such as in abruptio placentae.
B. Infection with gram negative bacteria which secrete an endotoxin that induces the generation of tissue factor.
C. Malignancy - particularly adenocarcinoma of the pancreas or prostate as well as promyelocytic leukemia.
D. Another less common cause is head trauma.
III. Clinical features
A. Subacute DIC - associated with thromboembolic complications such as DVT and PE as well as with vegetations on heart valves.
B. Acute DIC
1. Thrombocytopenia and depletion of coagulation factors leads to bleeding tendency.
2. This is worsened by increased degradation of fibrin to fibrin split products which interefere with fibrin polymeration and with platelet function.
3. Fibrin deposition into small blood vessels leads to tissue ischemia. The most vulnerable organ is the kidney, where fibrin deposition can lead to acute renal failure.
4. Hemolysis can occur through mechanical damage to the red blood cells secondary to the fibrin deposits.
5. Patient may experience neurological phenomena caused by ischemic injury to the brain.
IV. Laboratory findings
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i couldn't find your original thread but you said adenocacinoma of the pancreas does not cause DIC?
i think that question is poorly constructed cos it was asking for a cause of DIC
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i couldn't find your original thread but you said adenocacinoma of the pancreas does not cause DIC?
i think that question is poorly constructed cos it was asking for a cause of DIC
hmm...
I don't know why they deleted the thread - maybe it's bc I copy-pasted
the whole explanation (copyright issues?). If so, sorry to the admins...

@ chux - what's the source of that info?
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Originally Posted by Casandra View Post
hmm...
I don't know why they deleted the thread - maybe it's bc I copy-pasted
the whole explanation (copyright issues?). If so, sorry to the admins...

@ chux - what's the source of that info?
they wouldn't allow me paste the link.search"adenocarcinomas and dic"
its should be the 4th column posted by university of florida medicine
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they wouldn't allow me paste the link.search"adenocarcinomas and dic"
its should be the 4th column posted by university of florida medicine
yeah, I found your previous post
ok, I'm no endocrine expert and the material from UFM clearly gives an example of adenocarcinoma as a cause of DIC but to be honest I haven't found any information supporting that either in Rapid Review nor my home country patho book. And to tell you the truth - for the exam I will go with what the books say..
Thanks for the info though
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yeah...
well check pathoma too,page 35,its in the book

i dont know which qbank is that but you should write them bcos the information is wrong.
its also in wiki
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Originally Posted by chux View Post
yeah...
well check pathoma too,page 35,its in the book

i dont know which qbank is that but you should write them bcos the information is wrong.
its also in wiki
I'm not using pathoma.
thanks for your info
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yeah...
well check pathoma too,page 35,its in the book

i dont know which qbank is that but you should write them bcos the information is wrong.
its also in wiki

I searched in wikipedia and it only says that: pancreatic cancers can cause DIC. so the info is very general (adenocarcinoma is not specified). so maybe that would explain the whole thing? what do you think?
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Originally Posted by chux View Post
yeah...
well check pathoma too,page 35,its in the book

i dont know which qbank is that but you should write them bcos the information is wrong.
its also in wiki
Pathoma is not a peer-reviewed book so I won't count it as a book source.. sorry.. no disrespect, just a rule I have.
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let me quote pathoma pg35 under DIC
"Adenocarcinomas produce mucin which activates coagulation"

i just think you should know and write to the qbank
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Originally Posted by chux View Post
let me quote pathoma pg35 under DIC
"Adenocarcinomas produce mucin which activates coagulation"

i just think you should know and write to the qbank
Of course I will, once I find a reliable resource supporting adenocarcinoma issue (again, no disrespect, but Pathoma is not a published book, hence not reviewed so I can't solely rely on that especially if no other book supports that).
Please let me know if you find any other resource though
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Etiology
DIC usually results from exposure of tissue factor to blood, initiating the coagulation cascade (see Fig. 2: Hemostasis: Fibrinolytic pathway.). DIC occurs in the following clinical circumstances:

Complications of obstetrics (eg, abruptio placentae, saline-induced therapeutic abortion, retained dead fetus or products of conception, amniotic fluid embolism): Placental tissue with tissue factor activity enters or is exposed to the maternal circulation.
Infection, particularly with gram-negative organisms: Gram-negative endotoxin causes generation or exposure of tissue factor activity in phagocytic, endothelial, and tissue cells.
Cancer, particularly mucin-secreting adenocarcinomas of the pancreas and prostate and acute promyelocytic leukemia: Tumor cells express or release tissue factor.
Shock due to any condition that causes ischemic tissue injury and release of tissue factor


Well...check online there are somany other publications.this is from merckx manuals.takecare
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Originally Posted by chux View Post
Etiology
DIC usually results from exposure of tissue factor to blood, initiating the coagulation cascade (see Fig. 2: Hemostasis: Fibrinolytic pathway.). DIC occurs in the following clinical circumstances:

Complications of obstetrics (eg, abruptio placentae, saline-induced therapeutic abortion, retained dead fetus or products of conception, amniotic fluid embolism): Placental tissue with tissue factor activity enters or is exposed to the maternal circulation.
Infection, particularly with gram-negative organisms: Gram-negative endotoxin causes generation or exposure of tissue factor activity in phagocytic, endothelial, and tissue cells.
Cancer, particularly mucin-secreting adenocarcinomas of the pancreas and prostate and acute promyelocytic leukemia: Tumor cells express or release tissue factor.
Shock due to any condition that causes ischemic tissue injury and release of tissue factor


Well...check online there are somany other publications.this is from merckx manuals.takecare
thanks. I have checked it online but case-reports that popped up will not be a solid base for stating that this is a general rule.
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Old 08-24-2012
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who's arguing Adenocarcinomas is associated with DIC?
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Info From Robbins and cotran Pathologic Basis of disease

Quote:
Originally Posted by Casandra View Post
Of course I will, once I find a reliable resource supporting adenocarcinoma issue (again, no disrespect, but Pathoma is not a published book, hence not reviewed so I can't solely rely on that especially if no other book supports that).
Please let me know if you find any other resource though

Hope it helps.......just copy and paste

Thromboplastic substances can be derived from a variety of sources, such as the placenta in obstetric complications and the cytoplasmic granules of acute promyelocytic leukemia cells ( Chapter 13 ). Mucus released from certain adenocarcinomas can directly activate factor X, independent of factor VII.

Among cancers, acute promyelocytic leukemia and adenocarcinomas
of the lung, pancreas, colon, and stomach are most frequently associated with DIC.
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Originally Posted by Master shifu View Post
Hope it helps.......just copy and paste

Thromboplastic substances can be derived from a variety of sources, such as the placenta in obstetric complications and the cytoplasmic granules of acute promyelocytic leukemia cells ( Chapter 13 ). Mucus released from certain adenocarcinomas can directly activate factor X, independent of factor VII.

Among cancers, acute promyelocytic leukemia and adenocarcinomas
of the lung, pancreas, colon, and stomach are most frequently associated with DIC.
That's from Robbins book, right? Ok, now we've got a good source. I will let them know to correct the question. Thanks you guys! :-)
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