HYPERCOAGULABILITY

Question 1

single nucleotide mutation in factor V, seen in 2-15% of whites

Seen in 60% of DVT pts?

5x increased risk for thrombosis

50x increased risk for thrombosis

Answer 1

Leiden Mutation of Factor V

Heterozygotes

Homozygotes

Question 2

single nucleotide change in the 3’ untranslated region of prothrombin gene

Causes elevated prothrombin = increased risk for venous thrombosis

Answer 2

Prothrombin Mutation

Question 3

can be congenital or acquired

autosomal codominant, Heterozygotes have only 20-60% of normal ATIII levels?

Nephrotic syndrome, liver disease, contraceptives, pregnancy, DIC, venous thrombosis?

Answer 3

ATIII Deficiency

Congenital ATIII Deficiency

Acquired ATIII Deficiency

Question 4

occurs post-administration of unfractionated heparin

Answer 4

Heparin-Induced Thrombocytopenia Syndrome

Question 5

aka APS or “LupusAnticoagulant”

▪ Recurrent thrombosis
▪ Repeated miscarriages
▪ Cardiac valve vegetations
▪ Pulmonary embolism
▪ Pulmonary/renal HTN
▪ Stroke
▪ bowel infarction

In Vitro: False-positive serologic test for???

Answer 5

Antiphospholipid Antibody Syndrome

syphilis – interferes w/ the aPTT test

Question 6

what is primary Antiphospholipid Antibody Syndrome

Answer 6

people w/ only a hypercoagulable state (no autoimmunity)

Question 7

what is secondary Antiphospholipid Antibody Syndrome

Answer 7

people w/ autoimmune disease (like lupus)