This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
Congenital cause of hypercoagulable states are all except aEUR' 
Select and explain. 
A. Protein C deficiency, B. Protein S deficiency, C. MTHFR mutation, D. MTHFR mutation
D: MTHFR mutation
Answer: D: MTHFR mutation 
Explanation: Lupus anticoagulant [Ref: Harrison I7/e p. 7321 Causes of Hy ercoa ulable state Congenital * Factor V Leiden (5% of the population are heterozygous for FVL). * Prothrombin mutation (G202 WA, 5'UTR). * High homocysteine levels due to MTHFR mutation0 * Sickle-cell disease (only small risk) * Antithrombin III deficiency. * Protein C deficiencyQ. * Protein S deficiency0. * Plasminogen and fibrinolysis disorders (very rare) Acquired * Antiphospholipid antibodies - Anti-cardiolipin antibodies and/or - Lupus anticoagulants * Heparin-induced thrombocytopenia * Paroxysmal nocturnal hemoglobinuria * Nephrotic syndrome * Hyperestrogenemia * Estrogen-containing hormonal contraceptives * Tobacco smoking * Hyperhomocysteinemia due to vitamin I312 and folic acid deficiency.