A 62-year-old man with metastatic prostate cancer presents with sepsis, bruising, and bleeding from venepuncture sites. O/E: Febrile, tachycardic.
Investigations:
- Hb: 82 g/L
- Platelets: 45 × 10⁹/L
- PT: 24s (10–14) | APTT: 68s (25–35)
- Fibrinogen: 0.6 g/L (2–4)
- D-dimer: 8500 ng/mL
- Blood film: Schistocytes present
What is the MOST appropriate immediate management of his bleeding?
A
Give cryoprecipitate, fresh frozen plasma, and platelets now.
B
Give prothrombin complex concentrate (PCC) and IV Vitamin K.
C
Commence therapeutic dose LMWH for the suspected DIC event.
D
Administer IV tranexamic acid 1g bolus to stop the bleeding.
E
Arrange for urgent plasmapheresis to remove the microthrombi.