Thrombosis Flashcards

1
Q

Describe the process of protein C and protein S in stopping hemostasis

A

They inhibit factor V and VIII to stop clotting

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2
Q

Describe the antithrombin in stopping hemostasis

A
  • made in liver & circulates in blood
  • binds to thrombin to stop clotting
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3
Q

What happens if we have too much hemostasis

A

arterial thrombosis: stroke, heart attack

venous thrombosis: DVT, PE

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4
Q

What are the thrombotic mechanisms and risk factors associated with arterial clotting

A
  • underlying vascular disease
  • excess platelet activation
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5
Q

What are the thrombotic mechanisms and risk factors associated with venous clotting

A
  • stasis
  • failure to regulate thrombin generation
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6
Q

Describe the difference between arterial and venous clots

A

Arterial: primarily platelets with a little bit of fibrin

Venous: primarily fibrin with a little bit of platelets

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7
Q

Describe the difference in treatment between arterial and venous clotting

A

Arterial: RF mods & antiplatelet drugs (ASA)

Venous: prophylaxis, blood thinners

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8
Q

What things can cause both arterial and venous thrombosis

A
  • antiphospholipid antibodies
  • myeloproliferative disorders
  • heparin induced thrombocytopenia
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9
Q

Describe superficial thrombophlebitis

A

inflammation of superficial veins (tributaries of great saph)

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10
Q

What are the 5 major thrombophilias

A

Traditional (multiple mutations, rare, strong)
- antithrombin deficiency
- protein C deficiency
- protein S deficiency

Modern (point mutations, common, weak)
- factor V Leiden
- prothrombin gene mutation

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11
Q

Which thrombophilias have a failure to control thrombin generation

A
  • factor V leiden
  • prothrombin gene mutation
  • protein C & S deficiency
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12
Q

Describe the pathophysiology of factor V leiden

A

Point mutation in factor V gene at critical site involved in binding of fV to APC (protein C)

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13
Q

List some acquired triggers for thrombosis

A
  • immobilization
  • surgery
  • trauma
  • pregnancy/post partum
  • estrogens
  • age
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14
Q

Which genetic thrombophilias are generally weaker/asymptomatic

A
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15
Q

Which genetic thrombophilias are generally stronger/more symptomatic

A
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16
Q

When to work up someone for thrombophilia

A
  • strong family hx of thrombosis
  • recurrent thrombosis
  • unusual clinical presentation (young, unprovoked, unusual location)
17
Q

How long to treat a provoked clot

A

3-6 mos if no other genetic/fam hx

12 mos if… extensive clot burden, life-threatening provoked clot, persisting reversible risk factor

18
Q

How long to treat an unprovoked clot

A

lifelong anticoagulation