ÿþ<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"> <!-- Jeff Ascenzo Last Updated - 8/8/2013 --> <html> <head> <meta http-equiv="content-type" content="text/html;charset=iso-8859-1"> <meta name="generator" content="Adobe GoLive 6"> <title>Hypercoagulable States</title> </head> <body bgcolor="#aaaaaa"> <p> <font size = "2"> <b><u>Hypercoagulable States (Last Updated - 8/8/2013)</u></b><br> </font> <br> <font size = "1"> -can be either inherited or acquired:<br> <br> A) <u>Inherited:</u><br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;1) Factor V Leiden mutation --> most common inherited cause<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;2) <a href="Protein C.html">Protein C</a> or <a href="Protein S.html">Protein S</a> deficiency<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;3) <a href="Anti-Thrombin Deficiency.html">Anti-Thrombin III deficiency</a><br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;4) Hyperhomocysteinemia<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;5) Fibrinolysis defects<br> <br> B) <u>Acquired:</u><br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;1) Prolonged bedrest / immobilization<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;2) Myocardial Infarction (MI)<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;3) Trauma (Ex.) surgery or fracture)<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;4) DIC<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;5) Hyperlipidemia<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;6) Vasculitis<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;7) Multiple Myeloma<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;8) <a href="Lupus Anti-Coagulant.html">Lupus Anit-Coagulant</a> (Anti-Phospholipid Ab Syndrome)<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;9) Nephrotic Syndrome<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;10) Smoking<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;11) Cancer<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;12) Oral Contraceptives (OCP's)<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;13) Pregnancy<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;14) <a href="Warfarin.html">Warfarin (Coumadin)</a> --> @ initiation of tx until <a href="INR.html">INR</a> is therapeutic<br> <br> C) <u>Workup Prior To PFO Closure:</u><br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;1) Protein C Level<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;2) Protein S Level<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;3) Factor V Leiden Mutation<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;4) Factor VIII Level<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;5) Prothrombin Gene Mutation<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;6) Anti-Thrombin III Antibody<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;7) Anti-Cardiolipin Antibody<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;8) Homocysteine Level<br> <br> <br> ========================================================<br> <u>References:</u><br><br> First Aid for the USMLE Step 2. 2002. Pg. 202<br> </font> </p> </body> </html>