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Teaching Cases

Thrombosis – Thomas G. DeLoughery, MD
Oregon Health Sciences University, Portland, OR

Copyright of the American Society of Hematology, 2006. ISSN: 1931-6860.

I. HistoryII. Physical ExamIII. Laboratory DataIV. Differential Diagnosis
V. PathophysiologyVI. Prognosis/Clinical CourseVII. Teaching PointsVIII. Bibliography

VII. TEACHING POINTS

Three things to remember about coagulation
  • Initiated by exposure of tissue factor
  • Propagated by formation of thrombin
  • Cross-linked fibrin formation via thrombin and factor XIII
Four clues to a hypercoagulable state
  • Thrombosis at an early age
  • Recurrent thromboses
  • Thrombosis at an unusual site
  • Family history of thrombosis
Five most common inherited hypercoagulable states
  • Factor V Leiden
  • Prothrombin Gene Mutation
  • Protein S deficiency
  • Protein C deficiency
  • Antithrombin III deficiency
At least six acquired hypercoagulable states
  • Estrogen excess (oral contraceptives, pregnancy)
  • Malignancy
  • Antiphospholipid antibodies
  • Hyperhomocysteinemia
  • Inflammatory Bowel Disease
  • Nephrotic syndrome

View Bibliography

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