A patient is positive for fibrin degradation products and negative for D dimers. Which condition is most likely?
a. Systemic fibrinolysis
b. DIC
c. Hypofibrinogenemia
d. Deep vein thrombosis (DVT)
ANS: A
Fibrin degradation products are positive and D dimers are negative in systemic (also called primary) fibrinolysis. Plasmin is present, which degrades fibrinogen so that it is decreased. However, thrombin is not present, so no D dimers are formed. They are both elevated in DIC and DVT. Neither is useful for hypofibrinogenemia, which is diagnosed using a fibrinogen assay.
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