Which statement best describes disseminated intravascular coagulation?

• A. Bleeding only
• B. Clotting only
• C. Bleeding and clotting simultaneously
• D. Normal coagulation tests

Answer: (C)

Disseminated intravascular coagulation is a consumptive coagulopathy in which widespread activation of clotting leads to many small clots forming in the microvasculature. That ongoing clotting uses up platelets and coagulation factors, so the patient is also prone to bleeding as these resources become depleted. Clinically you can see both thrombosis and bleeding occurring together, rather than one or the other. Lab tests typically show abnormal coagulation tests (prolonged PT and aPTT), low platelets, low fibrinogen, and elevated markers of fibrin degradation (like D-dimer), reflecting both rampant clotting and consumption.