D.I.C. is seen in-
**Core Concept**
Disseminated Intravascular Coagulation (D.I.C.) is a complex condition characterized by the systemic activation of blood coagulation, leading to the formation of microthrombi in small blood vessels. This results in consumption of platelets and coagulation factors, ultimately causing hemorrhage and organ dysfunction.
**Why the Correct Answer is Right**
Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia (AML) that is strongly associated with D.I.C. This is due to the release of pro-coagulant substances, such as tissue factor, by the abnormal promyelocytes. The interaction between these pro-coagulant substances and the coagulation cascade triggers a cascade of events leading to D.I.C. The high incidence of D.I.C. in APL is thought to be responsible for the high mortality rate observed in these patients.
**Why Each Wrong Option is Incorrect**
**Option A:** is incorrect as it is a correct association. However, we need another option to explain why it is the correct answer.
**Option B:** Acute myelomonocytic leukemia is a subtype of AML, but it is not as strongly associated with D.I.C. as APL. While patients with acute myelomonocytic leukemia may develop D.I.C., it is not a characteristic feature of this disease.
**Option C:** Chronic myelomonocytic leukemia (CMC) is a type of myeloproliferative neoplasm that is not typically associated with D.I.C. This disease is characterized by the proliferation of monocytic cells, but it does not typically lead to the systemic activation of coagulation seen in D.I.C.
**Option D:** Autoimmune hemolytic anemia is a condition characterized by the destruction of red blood cells due to autoantibodies. While patients with autoimmune hemolytic anemia may develop thrombocytopenia, it is not typically associated with D.I.C.
**Clinical Pearl / High-Yield Fact**
A key feature of D.I.C. is the presence of schistocytes in the peripheral blood smear, which are fragmented red blood cells. The presence of schistocytes should raise suspicion for D.I.C. and prompt further investigation.
**β Correct Answer: A. Acute promyelocytic leukemia**