Endothelial damage increases the risk of thrombus formation through many mechanisms. One thing that happens when endothelium gets ripped up is that tissue factor is exposed (which initiates the coagulation cascade). Conditions falling under this category of risk include atherosclerosis and bacterial sepsis. The next category, abnormal blood flow, applies to patients who undergo prolonged immobilization, or those who have varicose veins or atrial fibrillation. In these conditions, blood is allowed to pool or stagnate, increasing the chance that platelets and coagulation factors will meet up and start doing their thing. The final arm of the triad, hypercoagulability, includes a lot of different disorders such as oral contraceptive use, obesity, pregnancy, and smoking; the mechanisms underlying this category of risk are numerous and often poorly-understood.
So if you have a patient with a thrombus, don’t automatically jump to the conclusion that he or she has a hereditary thrombotic disorder, such as factor V Leiden! Many times, thrombi are caused by the presence of too many risk factors (e.g, a patient who smokes, takes oral contraceptives, and is obese). However, if there are not many risk factors present, you may want to consider the possiblility of a hereditary thrombotic disorder. You should start worrying if other family members have venous thrombi, if the thrombus is anywhere other than the leg veins or lungs, if the patient is young, or if there have been multiple thrombotic episodes.
We need your help! Pathology Student is completely ad-free.If you find us useful, please consider donating whatever feels right to you. Every bit helps!You can donate here.
- frank forte said some of the hs cases have a slightly hi mchc in our practice . Prhaps this is related to the sphere&...
- Maya said I have one question, that I can’t find the answer in the books.. What does it mean, when someb...
- Kristine said I don’t think I have that phrase in my post – but I can comment on a few things. In anap...
- shadan said What do u mean by’ streaming nuclear polarity’ .
- Kristine said Sure! There’s a list of quizzes here, and there are a few more if you search for “quiz...
- Jovana said Thank you! Very usefull. ^^
- Akunwata Chima said I enjoyed your quiz. Can I have more?
- emad said Thanks alot ,
- kawi said Thank you very much …. I would like to learn more from you .
- felicia said thanks
- Lusi said Can’t wait to see it!!
- Kristine said Yes, I do! I plan to include it in that “all our books for X$” thing; it would be about...