4.9 Clotting Cascade Flashcards Preview

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Flashcards in 4.9 Clotting Cascade Deck (109)
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61

Endothelial injury can be due to

trauma,
ischemia (MI),
atherosclerosis,
endotoxins,
cigarette smoke,
autoimmunity

62

Common pathway

exposure of subendothelial connective tissue to plasma and/or phenotypic changes in endothelial cells

63

on a smear of a heavy smoker

you see weird looking cells that are killed endothelial cells

64

left ventricle thrombus

get into carotids leading to stroke

65

right ventricle thrombus

getin into capilaries of lungs

66

septal defects and thrombi

normally if there is a septal defect the pressure on the right is more than the left so flow occurs nromally, but if the valsalva maneuver occurs then there can be a reversal of flow causing problems

67

stasis/turbulents disrupts

laminar flow

68

stasis/turbulence stresses

endothelium

69

stasis/turbulence diminishes

anticoagulants

70

stasis/turbulents concentrates

procoagulants

71

does moving stasis disturb flow

no

72

stasis/turbulence excludes

inhibitors

73

during stasis/turbulence

more activate clotting factors, and potential for clotting is reduced, along with inhition of clotting

74

where is the most common place for thrombotic events

deep veins

75

why is the most common place for thrombotic events the deep veins

bc under the valves of deep veins there are eties of turbulence

76

hypercoagulability can occur due to

inherited deficiencies in anticoagulants,
heparin induced thrombocytopenia,
antiphospholipid antibodies,
medications/prostheses,
sickle cell disease

77

how does heparin induce thrombocytopenia

when a large MW heparin is givin,
Ab forms agains it that cross react with platelets.
So the next time you give the heparin there is a huge rise in Ab that bind the platelets and use them up

78

what disease is associated with antiPL antibodies

lupus, seen in young wooen - these tend to coressreact with platelets too

79

hypercoag - leiden mutation for factor 5( replacing glut for arg) makes factor 5 resistant to ceavage by

protein C - seen in 2 - 15% of caucasians

80

hypercoag - mutation in prothrombin causing

prothrombin to inc - seein in 1-2% of population

81

homocysteinemia is correlated with_..and can be treated with_..

cardiovascular disease__.vitamins

82

deficiencies in Protein S and C

hypercoaguable bc no cleavage of factor 5

83

who should be suspected for inherited hypercoaguable states?

patients under 50 who thrombose with no underlying cause

84

hypercoag - fibrolytic activity

this is an inhibition of coagulation bc it eats up the ealy nascent clots - loss of this ability makes you more hypercoaguable

85

effects of aniPL

recurrent arterial/venous thromboses,
miscarriages,
cardiac valve vegetations,
thrombocytopenia

86

post mortem clots

chicken fat and currant jelly due to gravity

87

antemortem clots

Lines of Zahn - blood is moving so it looks like its stirred with a stick

88

Mural thrombi

walled - in the walls of the heart

89

Fate of Thrombi

Propogation,
Dissolution,
organization and recanalization,
embolization

90

what does heparin do

helps to prevent propagation, it DOES NOT dissolve clots