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Disseminated intravascular coagulation — USMLE Step 2 CK MCQ

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EasyInternal MedicineDisseminated intravascular coagulationUSMLE Step 2 CK

A 43-year-old Hispanic woman comes to the hospital because of progressive symptoms. History and focused examination are notable for sepsis with bleeding, thrombocytopenia, prolonged PT, and elevated D-dimer. Temperature is 102.2°F (39.0°C), blood pressure is 108/66 mmHg, pulse is 112/min, respirations are 22/min, and oxygen saturation is 94% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most likely diagnosis?

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Correct answer: B — Disseminated intravascular coagulation

The vignette describes Disseminated intravascular coagulation, supported by sepsis with bleeding, thrombocytopenia, prolonged PT, and elevated D-dimer. Disseminated intravascular coagulation is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: Surviving Sepsis Campaign 2021 Guideline