03 Hypercoagulable States

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