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Medical Emergencies · patient case with 1 question

29-year-old with Factor V Leiden

Scenario: A 29-year-old patient has FACTOR V LEIDEN.

Question 1

What is NOT true about this condition?

  1. Oral contraceptives interfere with clot formation in these patients
  2. It causes resistance to inactivation by activated protein C
  3. It is the most common inherited thrombophilia in people of European descent
  4. It increases the risk of deep vein thrombosis and pulmonary embolism
Show answer and explanation

Correct answer: A. Oral contraceptives interfere with clot formation in these patients

  • A. Correct — this is the FALSE statement. Factor V Leiden is a HYPERCOAGULABLE state, and oestrogen-containing contraceptives do the opposite of interfering with clotting: they substantially INCREASE thrombotic risk, and the combination of Factor V Leiden plus oral contraceptives multiplies the risk of venous thromboembolism.
  • B. True. The point mutation renders factor Va resistant to cleavage by activated protein C, so the natural anticoagulant brake fails and thrombin generation continues unchecked.
  • C. True. Factor V Leiden is the most common inherited thrombophilia in populations of European ancestry.
  • D. True. The clinical consequence is venous thrombosis — DVT, pulmonary embolism, and pregnancy-associated thrombotic complications.

Note: Dental relevance: these patients BLEED normally. Many are on long-term warfarin or a DOAC, and it is the ANTICOAGULANT — not the thrombophilia — that governs bleeding management.

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