Haematopathology: DIC: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Haematopathology: DIC

Sample item

A woman with placental abruption develops bleeding from venepuncture sites. Laboratory results show prolonged PT and aPTT, low platelets, low fibrinogen, raised D-dimer and fragmented red cells on smear. What is the central mechanism?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Widespread activation of coagulation by tissue factor release, with consumption of platelets and clotting factors

Obstetric complications release tissue factor, activating the coagulation cascade throughout the circulation. Microthrombi cause schistocytes, and consumption of platelets, fibrinogen and factors with secondary fibrinolysis leads to bleeding. PT and aPTT are prolonged with raised D-dimer.

Option by option

  • A. Deficiency of ADAMTS13 with ultra-large von Willebrand multimers

    ADAMTS13 deficiency causes TTP, with normal PT, aPTT and fibrinogen.

  • B. Inherited deficiency of factor VIII

    Factor VIII deficiency gives a prolonged aPTT with normal PT and platelets.

  • C. Widespread activation of coagulation by tissue factor release, with consumption of platelets and clotting factors (correct)

    Correct. Consumption coagulopathy explains the entire laboratory pattern.

  • D. Autoantibody against platelet glycoprotein IIb/IIIa

    Anti-GpIIb/IIIa antibodies cause ITP, with isolated thrombocytopenia and a normal PT.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Widespread activation of coagulation by tissue factor release, with consumption of platelets and clotting factors. Obstetric complications release tissue factor, activating the coagulation cascade throughout the circulation.

Why is "Deficiency of ADAMTS13 with ultra-large von Willebrand multimers" not the answer?

ADAMTS13 deficiency causes TTP, with normal PT, aPTT and fibrinogen.

Why is "Inherited deficiency of factor VIII" not the answer?

Factor VIII deficiency gives a prolonged aPTT with normal PT and platelets.

Why is "Autoantibody against platelet glycoprotein IIb/IIIa" not the answer?

Anti-GpIIb/IIIa antibodies cause ITP, with isolated thrombocytopenia and a normal PT.

What concept does this question test?

It tests Haematopathology: DIC in Pathology. Microthrombi cause schistocytes, and consumption of platelets, fibrinogen and factors with secondary fibrinolysis leads to bleeding. PT and aPTT are prolonged with raised D-dimer.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haematopathology: DIC?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.