A 17-year-old boy is brought to the emergency department by a friend after he briefly lost consciousness during a workout. He has been spending 3-4 hours of running to prepare for a marathone. He is oriented to person and place, but not time; he appears irritable. His temperature is 40.5°C (104.9°F), pulse is 118/min, respirations are 24/min, and blood pressure is 95/70 mm Hg. The patient is profusely sweating and is confused. His pupils are equal and reactive to light. Neurologic examination shows no focal findings. Laboratory results are as follows: Which of the following sets of hematologic findings is most likely to be present in this patient?

Question

A 17-year-old boy is brought to the emergency department by a friend after he briefly lost consciousness during a workout. He has been spending 3-4 hours of running to prepare for a marathone. He is oriented to person and place, but not time; he appears irritable. His temperature is 40.5°C (104.9°F), pulse is 118/min, respirations are 24/min, and blood pressure is 95/70 mm Hg. The patient is profusely sweating and is confused. His pupils are equal and reactive to light. Neurologic examination shows no focal findings. Laboratory results are as follows:  Which of the following sets of hematologic findings is most likely to be present in this patient?

Quizplus · Accepted Answer

Eductional Objective: Disseminated intravascular coagulation is marked by widespread activation of the coagulation cascade, leading to excessive thrombin production and formation of microthrombi.  Subsequent conversion of plasminogen to plasmin results in increased fibrinolysis to clear the thrombi.  Laboratory studies show a consumption of clotting factors (prolonged PT/PTT) and platelets (thrombocytopenia) and signs of excessive fibrinolysis (eg, elevated D-dimer).

A 17-Year-Old Boy Is Brought to the Emergency Department by a Friend