<prompt> Virchows triad includes all of the following, EXCEPT?Venous stasisInjury to veinsBlood hypercoagulabilityVenous thrombosis  <response>: Ans. is d i.e., Venous thrombosis Virchows triad refers to three primary influences that predispose to thrombus formation. a Endothelial injury or vascular injury b Stasis or turbulence of blood flow c Blood hypercoagulability Virchows triad should be the cornerstone for assessment of risk factors for deep venous thrombosis. Stasis can occur with venous insufficiency, severe hea failure, or prolonged bed rest or immobility of an extremity following coma, pelvic or limb fracture, paralysis, extended airplane travel, or a lengthy operation. Endothelial injury can result from direct trauma severed vein, venous cannulation, or transvenous pacing or local irritation secondary to infusion of chemotherapy, previous DVT, or phlebitis. - Damaged endothelium leads to platelet aggregation, degranulation and formation of thrombosis as well as vasoconstriction ad activation of the coagulation cascade. Hypercoagulable state can be inherited or acquired. These are - def of antithrombin III, protein C or S - increased homocysteine - factor V Leiden mutation - prothrombin gene mutation - antiphospholipid syndrome - paroxysmal nocturnal hemoglobinuria - malignancy lung cancer - most commonly pancreas, prostate, breast, ovary etc... - nephrotic syndrome - pregnancy, high dose estrogen therapy or OCPs. Some impoant questions on deep vein thrombosis Homans sign -- Calf tenderness on forced ankle dorsiflexion. Phlegmasia alba dolens -- Painful white leg - Phlegmasia cerulea dolens -- Painful blue leg Moses Sign -- Calf tenderness on direct pressure on the calf. Pratts Sign -- Calf tenderness on squeezing the calf from the sides. - Duplex ultasound is the diagnostic modality of choice in deep vein thrombosis. 