Thrombotic Disorders — Clinical

A 38-year-old woman presents with recurrent deep vein thrombosis (DVT) of the lower limbs despite 6 months of anticoagulation therapy. She has no family history of thrombophilia and her recent imaging shows a new thrombosis in the contralateral leg. Which investigation is most appropriate to establish the underlying prothrombotic state?

A 38-year-old woman presents with recurrent deep vein thrombosis (DVT) of the left lower limb and a spontaneous pulmonary embolism 6 months ago. She has no family history of thrombophilia and is not on oral contraceptives. Physical examination reveals mild splenomegaly. Routine coagulation studies (PT, aPTT, platelet count) are normal. Which investigation is most appropriate to establish the diagnosis?

A 38-year-old woman presents with recurrent venous thromboembolism (DVT and PE) despite therapeutic anticoagulation. Investigations reveal elevated homocysteine levels and normal protein C, protein S, and antithrombin III activity. Which single feature best distinguishes homocysteinemia from inherited thrombophilias (protein C/S deficiency, antithrombin deficiency)?

Which of the following is the most common inherited thrombophilia in the Caucasian population?

A 34-year-old woman presents to the emergency department with acute onset severe headache, confusion, and fever (38.5°C). On examination, she has petechial rash over the lower extremities and trunk. Laboratory investigations reveal: Hb 9.2 g/dL, WBC 18,500/μL, platelets 45,000/μL, PT 18 s (normal 12–14 s), aPTT 42 s (normal 26–36 s), fibrinogen 120 mg/dL (normal 200–400 mg/dL), D-dimer >5000 ng/mL. Blood culture is pending. What is the most likely diagnosis?