Haemodynamics: Trousseau syndrome: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Haemodynamics: Trousseau syndrome

Sample item

A 62-year-old man with weight loss and epigastric pain develops recurrent migratory superficial venous thrombosis at different sites. Which mechanism best explains the thrombosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Tumour-derived procoagulants such as tissue factor and mucins, producing a hypercoagulable state

Migratory thrombophlebitis (Trousseau syndrome) is a paraneoplastic hypercoagulable state, classically with pancreatic body and tail carcinoma, and also lung and gastric cancers. Mucin and tissue factor released by tumour cells activate the coagulation cascade. It may be the first sign of an occult malignancy.

Option by option

  • A. Stasis from varicose veins with incompetent valves

    Varicose veins cause stasis thrombosis in the same area, not thrombosis migrating between different sites.

  • B. Autoantibodies against platelet factor 4 and heparin complexes

    Antibodies to platelet factor 4 and heparin cause heparin-induced thrombocytopenia, which needs heparin exposure.

  • C. Necrotising vasculitis of medium-sized arteries causing endothelial injury

    Medium-vessel vasculitis such as polyarteritis nodosa causes arterial ischaemia and not migratory venous thrombosis.

  • D. Tumour-derived procoagulants such as tissue factor and mucins, producing a hypercoagulable state (correct)

    Correct. Tumour procoagulants cause a systemic hypercoagulable state that migrates between sites.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is D, Tumour-derived procoagulants such as tissue factor and mucins, producing a hypercoagulable state. Migratory thrombophlebitis (Trousseau syndrome) is a paraneoplastic hypercoagulable state, classically with pancreatic body and tail carcinoma, and also lung and gastric cancers.

Why is "Stasis from varicose veins with incompetent valves" not the answer?

Varicose veins cause stasis thrombosis in the same area, not thrombosis migrating between different sites.

Why is "Autoantibodies against platelet factor 4 and heparin complexes" not the answer?

Antibodies to platelet factor 4 and heparin cause heparin-induced thrombocytopenia, which needs heparin exposure.

Why is "Necrotising vasculitis of medium-sized arteries causing endothelial i…" not the answer?

Medium-vessel vasculitis such as polyarteritis nodosa causes arterial ischaemia and not migratory venous thrombosis.

What concept does this question test?

It tests Haemodynamics: Trousseau syndrome in Pathology. Mucin and tissue factor released by tumour cells activate the coagulation cascade. It may be the first sign of an occult malignancy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haemodynamics: Trousseau syndrome?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.