Fast Five Quiz: Test Your Knowledge of Venous Thromboembolism

Cheong Jun Lee, MD


December 03, 2018

Nephrotic syndrome is one of several disease states that increase a patient's risk of developing VTE. VTE associated with nephrotic syndrome appears to be due to a hypercoagulable state resulting from urinary loss of anticoagulant proteins, together with a simultaneous increase in clotting factors.

The menopausal state itself does not confer an increased risk for VTE. Estrogen-containing hormone therapy (HT) to treat menopausal symptoms can increase risk a patient's risk of developing VTE; however, the incidence is low.

Whereas inflammatory bowel disease increases a patient's risk for VTE, irritable bowel syndrome does not produce the same increase in risk.

Long bone, hip, and pelvic fractures are associated with an increased risk for VTE. Flat bone fractures, such as skull fractures, are not included in this grouping.

Several other factors place patients at increased risk for VTE. Patient-related risk factors for VTE include the following:

  • Age > 40 years

  • Obesity

  • Varicose veins

  • Use of exogenous estrogen in pharmacologic doses (eg, oral contraceptives, HT)

  • Immobility and inactivity

Disease states that increase risk for VTE include the following:

  • Cancer

  • Congestive heart failure

  • Nephrotic syndrome

  • Recent myocardial infarction

  • Inflammatory bowel disease

  • Spinal cord injury with paralysis

  • Pelvic, hip, or long bone fracture

Surgical factors are related to procedure type and procedure duration. Both hip and knee surgery confer an increased risk for DVT.

Hematologic disorders that increase risk of developing VTE include the following:

  • Factor V Leiden mutation

  • Protein C or protein S deficiency

  • Activated protein C resistance

  • Antithrombin III deficiency

  • Lupus anticoagulant

  • Polycythemia vera

  • Paroxysmal nocturnal hemoglobinuria

  • Dysfibrinogenemia

  • Prothrombin mutation

For more on the risk factors for VTE, read here.


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