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Combined contraception VTE risk — USMLE Step 3 MCQ

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HardOB/GYN (prenatal care, contraception, screening)Combined contraception VTE riskUSMLE Step 3

A 38-year-old woman started a combined estrogen-progestin contraceptive pill 2 months ago. She now has unilateral calf swelling and pleuritic chest pain. CT pulmonary angiography confirms pulmonary embolism. She has no cancer or recent surgery. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: D — Estrogen-mediated increase in hepatic clotting factor production

Estrogen-containing contraception increases VTE risk by altering hepatic coagulation factor synthesis.

Reference: CDC U.S. Medical Eligibility Criteria for Contraceptive Use: https://www.cdc.gov/contraception/