0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Correspondence and Brief Communications |

Treatment Considerations for Inherited Thrombophilia and Pulmonary Embolus

Robert J. Baker, MD
Arch Surg. 2001;136(2):237. doi:10.1001/archsurg.136.2.237.
Text Size: A A A
Published online

Extract

The article by Blaszyk and Björnsson1 in the December issue of the ARCHIVES is one of many recently published concerning the factor V Leiden (FVL) mutation. The "big three" of thrombophilias (hypercoagulability states) used to be antithrombin deficiency, deficiency of protein C, and deficiency of protein S. Antithrombin III inactivates clotting factors Xa and XIII; although most patients have an acquired deficit, approximately 1 in 1000 individuals in the United States have a congenital deficit with an identified genetic defect (an autosomal dominant). Likewise, protein C and S deficits are ordinarily acquired (commonly from vitamin K deficiency) but can be inherited; these factors interfere with blood clotting by blocking factors V and VIII in the intrinsic cascade. The fourth and most common inheritable thrombophilia is now the FVL mutation, which results in resistance to activated protein C with the potential for causing spontaneous intravascular clotting. This is manifested primarily as spontaneous venous thrombosis but can occasionally cause pulmonary embolus and, less commonly, arterial obstruction.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature
Thromboembolism or Acute Pulmonary Embolism

Users' Guides to the Medical Literature
Table 9.2-3 Refuted Evidence From Observational Studiesa

brightcove.createExperiences();