All of the following are aquired causes of Hypercoagulability, Except
Answer is None or A (Infection) Infection has not been mentioned as a direct cause of hypercoagulability in any standard textbook and is the single best answer of exclusion. Acquired Condition Mechanism of Hyper Coagulability * Antiphospholipid syndrome * Autoantibodies to negatively charged phospholipids -> / p I ate 1 et adhesion * Heparin-induced thrombocytopenia * Antibodies to platelet factor 4 --> platelet activation * Malignancy * Tumor cell induction of tissue factor expression * Myeloproliferative syndromes * Elevated blood viscosity, altered platelets * Nephrotic syndrome * Loss of antithrombin III in urinel. Fibrinogen,/ platelet activation * Oral contraceptive use, estrogen replacement therapy * /Hepatic synthesis of coagulation factos and/or effects of estrogen on endothelium (effect may be more prominent in patients with underlying primary hypercoagulability) * Paroxysmal nocturnal hemoglobinuria * Unknown, possibly "leaky" platelets * Postpaum period /Pregnancy * Venous stasis, increased coagulation factors, tissue trauma * Surgery /trauma (postoperative period) * Venous stasis, immobilization, tissue injury * Inflammatory Bowel Disease * * Increased inflammatory mediators down regulate thrombomodulin leading to impaired generation of APC. Elevated levels of factor VIII, Fibrinogen; ,I, Protein S activity. Prolonged surgery has been directly mentioned in association with hypercoagulable states in some standard text books including 'Washington Manual of Hematology and Sub specialty consult' Also 'postoperative state' is an established cause of hypercoagulability (CMDT) and hence prolonged surgery has been included as a correct option.
Infection
Inflammatory Bowel disease
Myeloproliferative disorders
Prolonged surgery > 1 hour