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Internal Medicine
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Answer 1
- Past history of thrombosis.
Past history of thrombosis is not part of the Virchows triad. Damage to the vessel wall causes a dysfunctional endothelium followed by increased platelet activation and aggregation. This process also inhibits the initiation of local fibrinolysis. Venous stasis causes decreased flow, which in turn inhibits the clearance and dilution of activated coagulation factors. The normal clotting-fibrinolytic system involves a fine balance between activation and inhibition of platelets, procoagulant factors, anticoagulant factors, and fibrinolytic factors. The hypercoagulable conditions are a group of inherited and acquired disorders that predispose to venous thromboembolism.
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