Approach to hypercoagulable disorders Quiz: Ace Your Exams
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A 57-year-old woman is referred to the hematology clinic for follow-up due to a history of multiple thromboses and recent treatment for a mesenteric venous thrombosis. At the age of 26, during her second pregnancy, she was on bedrest for seven weeks and developed a right leg venous thrombosis. At the age of 43, she had a left leg venous thrombosis after sustaining a left pelvic and femoral fracture from a motor vehicle accident requiring extensive orthopedic surgery. The patient has never had arterial thrombosis. The patient has no evidence of cirrhosis, autoimmune conditions, or inflammatory bowel disease. She has a cousin with factor V Leiden mutation; however, her parents and siblings have no history of thromboses. Vital signs are within normal limits. On physical examination, the patient is well-appearing with a normal cardiopulmonary exam and no peripheral edema. Which of the following factors indicates the need for an evaluation for an underlying hypercoagulable disorder?
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