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Answer: D
This patient has many potential causes for a hypercoagulable state including bedrest, possible HIT from heparin flushes in his central venous catheter, carcinoma, and a possible inherited predisposition to thrombosis as suggested by his previous DVT. In terms of tests that should be done at this time, the genetic tests can be accurately interpreted, but should be done on a tissue sample different from the usual peripheral blood leukocyte sample due to the circulating white cells from the transplant donor.
The other tests should not be performed until the patient is stable and more time has passed after the acute event and the treatment for it is completed. The patient currently has liver function abnormalities that might affect his synthetic function, so the coagulation screening tests and the protein C, protein S, and antithrombin levels may be abnormal; however, they would not be indicative of a hereditary thrombophilia.
Reference:
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Seligsohn U, Lubetsky A. Genetic suseptibility to venous thrombosis. New Eng J Med 2001; 344:1222-31.
Category: Hematology MCQs
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