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Coagulation Disorders: Acquired

Acquired coagulation disorders are those abnormalities of coagulation which can occur secondary to diseases in previously normal individuals.
Lack of vitamin K can cause a loss of functionality in vitamin K-dependent coagulation factors, specifically factors II, VII, IX and X. Most often associated with a diet lacking in Vitamin K, it may also present in situations of broad spectrum antibiotic use, where normal flora in the gut have been eliminated. As one might expect, treatment involves a diet rich in Vitamin K containing foods, and judicious use of broad spectrum antibiotics.
Disseminated intravascular coagulation (DIC) is best described as a disorder of consumption, because clotting factors are depleted from the blood. Basically, clotting occurs randomly throughout the body, as opposed to just in the localized areas where vascular damage has occurred, consuming clotting factors and platelets in the process. Symptoms may range from a mild bleed, to severe, profuse bleeding, primarily dependent upon the availability of clotting factors. As more and more coagulation factors and components are consumed, the disorder progresses and symptoms worsen. Most heavily impacted are the levels of factors I, V, and VIII as well as the number of available platelets. Clinically, DIC is detected via an elevated (positive) FDP, positive D-dimer test, a prolonged PT and APTT, plus the manifestation of hemorrhagic episodes. DIC is diagnosed as two primary types, acute and chronic.
  • Acute DIC manifests in a few hours or a few days, has a high mortality rate, and is seen in infections, obstetric complications, liver disease, and tissue injury.
  • Chronic DIC is a secondary condition to some other disease state. Once you treat the primary disease, this type of DIC will go away.
Treatment is often factor replacement therapy through the use of fresh frozen plasma and/or cryoprecipitate.