In disseminated intravascular coagulation, the first step in management is to...

• A. Stop anticoagulation therapy
• B. Treat the underlying cause as the first step
• C. Platelet transfusion immediately
• D. Corticosteroids

Answer: (B)

In disseminated intravascular coagulation, the driving factor is a trigger that sets off widespread coagulation, consuming platelets and clotting factors. The first step in management is to treat the underlying cause (for example, infection, obstetric catastrophe, trauma, malignancy, or pancreatitis) because stopping or removing that trigger stops the ongoing activation of coagulation and allows the system to reset. Supportive measures, such as transfusions, are reserved for active bleeding or before procedures, not the initial move. Stopping anticoagulation is not the primary action since it does not address the root cause and could worsen bleeding if platelets or factors are depleted. Corticosteroids aren’t used routinely unless a specific non-DIC indication is present.