Hypercoagulable States Flashcards
List the 6 Hypercoagulable States:
Factor V Leiden, Lupus Anticoagulant, Malignancy, Protein C Deficiency, Activated Protein C Resistance, Protein S Deficiency
What is a hypercoagulable state?
It is a blood clotting disorder
What are synonyms for hypercoagulable states?
thrombophilia, prothrombotic state
Are hypercoagulable states inherited or acquired?
Either
Thrombosis
Formation of a blood clot within a vessel, blocking it
Fibrinolysis
Process that keeps clots from over growing
Define primary hypercoagulable state.
It is inherited, not acquired
List the primary, inherited hypercoagulable states
Protein C deficiency, Activated Protein C Resistance, Protein S deficiency, Factor V Leiden
What is the most common type of hypercoagulable state?
Activated Protein C Resistance
What other coagulable state is actually a sub type of Activated Protein C Resistance?
Factor V Leiden
What type of problems can the primary hypercoagulable states lead to?
VENOUS events only.
Which are the secondary hypercoagulable states?
Lupus anticoagulant and malignancy
What is going on in Factor V Leiden?
Protein C is activated (and trying to turn off Factor V!)but, because of this mutation, Factor V is resistant to it… so it takes 10 times longer than it should to bind to Factor V to turn it off!
Of all the congenital disorders, Factor V Leiden is most likely to lead to:
DVTs!
What types of clots does Lupus Anticoagulant form?
Arterial clots
Lupus anticoagulant is what type of syndrome?
Antiphospholipid syndrom (APS)
What do APSs do to the blood?
Make the blood very sticky.
What is the 1 in 5 rule with lupus anticoaulant?
1/5 people under 45 who have a stroke, 1/5 who have a DVT, 1/5 w/recurrent pregnancy loss (3 or more), 1/5 w/ lupus will test positive.
What is the most common cause of acquired hypercoagulable disorder?
malignancy
How does chemotherapy contribute to clotting?
It down regulates protein S and C.
10-20% of patients with their first DVT will have a:
Cancer diagnosis w/in 6 months
Describe the role Protein C plays in clotting
Protein C is a Vit K-dependent, NATURAL anticoagulant. Protein S is its cofactor. When activated, Protein C shuts down factors 5a and 8a, impeding further thrombin generation.
Difference between homozygous and heterozygous Protein C deficiency:
Homozygous could kill you, heterozygous could cause a DVT or 2.
What is mutated in Factor V Leiden?
The site where Activated Protein C would bind…. Thus, factor Va molecules can continue to enhance factor Xa’s conversion of prothrombin to thrombin and coagulation is NOT inhibited.
