Which of the following conditions predispose a patient to venous thromboembolic disease? 1. Carcinoma 2. COPD 3. Trauma 4. Thrombocytosis
a. 1, 2, and 3 only
b. 1 and 4 only
c. 2 only
d. 1, 3, and 4 only
ANS: D
Several conditions enhance the intravascular coagulability of the blood and predispose to venous thromboembolic disease (Box 28-1). The most frequent causes of an inherited hypercoagulable state are the factor V Leiden mutation and the prothrombin gene mutation, which together ac-count for 50% to 60% of cases. The major acquired risk factors for VTE include recent major surgery, trauma, immobilization, antiphospholipid antibody syndrome, malignancy, pregnancy, oral contraceptives, and myeloproliferative disorders. Vessel wall abnormalities are found most often in patients who have sustained trauma or have undergone major surgery.
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