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.
- ahmed said Thank you
- ahmed said Wonderful explanation
- ahmed said So nice explanation, you make pathology simple and comprehensive
- ahmed said Very useful lesson thank you very much,easily undrrstand
- Ayuba said Thanks for the explanation. Still want to know. Why are people with lupus antibodies present with th...
- fiona said thank you so much!
- Niloy said Alhamdulillah, i’v found answers at n8 b4 the exam…!
- Sahaja Parsa said What a thorough explanation! It makes me actually think about what those parameters ate as opposed t...
- HAMID IQBAL said It’s nice to get connected with Pathology community
- Kristine said Hi Maya – That’s a good question. When a lymphocyte is said to look “monocytoid...
- 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...