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.
- Kristine said Thanks, Meghan – I agree! It should be a primary concern, not an afterthought, and we need to...
- Meghan J said Thank you for this post. It’s a topic that is often added as an afterthought to medical schoo...
- Kristine said Thanks, Sumayya!
- sumayya roohi said mantle cell lymphoma is CD 5+.CD 23-, CD 79b+, FMC7 and cyclin D1 +
- Kristine said I would presume so – at least as long as it remained in the blood.
- Kristine said “Open” chromatin means that you can see through the chromatin – it appears fine, l...
- Kristine said Thanks, Julia!! So glad you found it and it was helpful
- mcray aboagye said Thanks
- ikondere julius said thanx so much
- Kristine said No – I’m sorry, we’re all sold out.
- Rachel Nicholson said Are these shirts still available?
- Amanulla said And Macrocyte + Hypersegmented neutrophil=Megaloblastic anemia