A 67-year-old man in previously good health is hospitalized because of a 2-day history of fever and diminished consciousness. The patient responds inconsistently to verbal commands. His temperature is 39.5 °C (103.1 °F); he has tachycardia, and his blood pressure is 80/58 mm Hg. There is no bleeding. His hemoglobin is 12.1 g/dL, leukocyte count is 29,000/?L with 80% neutrophils, and platelet count is 20,000/?L. Which of the following studies should be obtained in this patient?
A)Bone marrow aspiration and biopsy
B)Factor VIII level
C)Measurement of platelet-associated IgG
D)Measurements of fibrin D-dimer and total fibrinogen
E)Bleeding time

Question

Quizplus · Accepted Answer

The patient's presentation suggests sepsis with possible disseminated intravascular coagulation (DIC), indicated by fever, altered mental status, hypotension, high white blood cell count, and notably low platelet count. Measurements of fibrin D-dimer and total fibrinogen are appropriate to assess for DIC.

A 67-Year-Old Man in Previously Good Health Is Hospitalized Because