Hypercoagulable States

Question 1

List the 6 Hypercoagulable States:

Answer 1

Factor V Leiden, Lupus Anticoagulant, Malignancy, Protein C Deficiency, Activated Protein C Resistance, Protein S Deficiency

Question 2

What is a hypercoagulable state?

Answer 2

It is a blood clotting disorder

Question 3

What are synonyms for hypercoagulable states?

Answer 3

thrombophilia, prothrombotic state

Question 4

Are hypercoagulable states inherited or acquired?

Answer 4

Either

Question 5

Thrombosis

Answer 5

Formation of a blood clot within a vessel, blocking it

Question 6

Fibrinolysis

Answer 6

Process that keeps clots from over growing

Question 7

Define primary hypercoagulable state.

Answer 7

It is inherited, not acquired

Question 8

List the primary, inherited hypercoagulable states

Answer 8

Protein C deficiency, Activated Protein C Resistance, Protein S deficiency, Factor V Leiden

Question 9

What is the most common type of hypercoagulable state?

Answer 9

Activated Protein C Resistance

Question 10

What other coagulable state is actually a sub type of Activated Protein C Resistance?

Answer 10

Factor V Leiden

Question 11

What type of problems can the primary hypercoagulable states lead to?

Answer 11

VENOUS events only.

Question 12

Which are the secondary hypercoagulable states?

Answer 12

Lupus anticoagulant and malignancy

Question 13

What is going on in Factor V Leiden?

Answer 13

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!

Question 14

Of all the congenital disorders, Factor V Leiden is most likely to lead to:

Answer 14

DVTs!

Question 15

What types of clots does Lupus Anticoagulant form?

Answer 15

Arterial clots

Question 16

Lupus anticoagulant is what type of syndrome?

Answer 16

Antiphospholipid syndrom (APS)

Question 17

What do APSs do to the blood?

Answer 17

Make the blood very sticky.

Question 18

What is the 1 in 5 rule with lupus anticoaulant?

Answer 18

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.

Question 19

What is the most common cause of acquired hypercoagulable disorder?

Answer 19

malignancy

Question 20

How does chemotherapy contribute to clotting?

Answer 20

It down regulates protein S and C.

Question 21

10-20% of patients with their first DVT will have a:

Answer 21

Cancer diagnosis w/in 6 months

Question 22

Describe the role Protein C plays in clotting

Answer 22

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.

Question 23

Difference between homozygous and heterozygous Protein C deficiency:

Answer 23

Homozygous could kill you, heterozygous could cause a DVT or 2.

Question 24

What is mutated in Factor V Leiden?

Answer 24

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.

Question 25

What is Protein S’s main role?

Answer 25

To serve as a cofactor and activate protein C.

Question 26

For either Protein C or S, the problem is either;

Answer 26

not enough or malfunctioning of the protein