Which of the following is a hypercoagulable state associated with increased risk of DVT?

• A. Factor V Leiden
• B. Cancer
• C. HELLP syndrome
• D. Factor V Leiden, Cancer, and HELLP syndrome

Answer: (D)

Hypercoagulable states raise the risk of venous thromboembolism, including DVT. Factor V Leiden causes resistance to activated protein C, shifting the balance toward clot formation and increasing DVT risk. Cancer creates a prothrombotic environment through tumor cells producing procoagulants, inflammatory cytokines, and platelet activation, all promoting clots. HELLP syndrome occurs in pregnancy with endothelial injury and coagulation activation, and pregnancy itself is a hypercoagulable state, especially around delivery, further elevating DVT risk. Taken together, all three conditions can predispose to DVT, so the most complete answer reflects that these are all associated with a hypercoagulable state increasing DVT risk.