The Curbsiders Internal Medicine Podcast #391 Hypercoagulable Work-Up with Dr. Jean Connors
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Apr 24, 2023 AI Snips
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Targeted History Guides Testing
- Ask about prior thrombosis triggers, age at events, and first-degree family history when evaluating VTE.
- Use these details to judge likelihood of inherited thrombophilia and need for testing.
Test Only If Actionable
- Only test for inherited thrombophilia if results will change management or help family counseling.
- Avoid testing during acute illness to prevent misinterpretation and unnecessary lifelong anticoagulation.
Timing Tests To Avoid False Results
- Order DNA tests (Factor V Leiden, prothrombin G20210A) anytime since they're PCR-based.
- Delay protein C, protein S, and antithrombin testing until off anticoagulation and out of acute inflammation.