03 Hypercoagulable States

Virchow's Triad

Common Hypercoagulable States

• inflammation: ongoing clot formation

• DVT/PE common

Inherited Hypercoagulable States

• also antiphosphilid syndrome

Factor 5 Leiden

Prothrombin Gene Mutation

• make excess prothrombin

AIII

• given high dose of heparin but no change in PTT

Protein C/S

Antiphospholipid

• arterial thrombosis uncommon

• 3 anti-phospholipid antibodies

• RPR antigen bound by syphillis antibodies, but also can be bound by anti-cardiolipin antibodies

• intrinsic cascade requires phospholipids. In body on cell membrane. In lab added extrinsically. Lupus anticoagulant will inactivate phospholipids added = false prolongation of PTT

• contact factor activates 12

• people have antibodies but not syndrome

• clotting factors: blue circles

• lupus anticoagulant: triangles

• mixing study: still prolonged PTT

• hemophilia: clotting factor deficiency

• unprovoked: didn't occur after plane flight/surgery