skip to main content

Cancer-Associated DIC — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardHaematologyCancer-Associated DICRACP Adult Medicine

A 70-year-old woman with metastatic pancreatic cancer develops progressive bilateral leg swelling, Trousseau syndrome (migratory superficial thrombophlebitis), and laboratory evidence of chronic DIC (mildly prolonged PT/APTT, mildly low fibrinogen, elevated D-dimer). She has no active bleeding. What is the most appropriate anticoagulation strategy?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Heparin infusion

Chronic DIC with predominant thrombosis (Trousseau syndrome) in malignancy requires therapeutic anticoagulation. LMWH is preferred over warfarin for cancer-associated VTE. In chronic compensated DIC without bleeding, replacement therapy is not indicated. The underlying malignancy drives the coagulopathy; treatment of cancer is the definitive therapy.

Reference: BSH – 2024 – Cancer-Associated VTE; ISTH 2024