Thrombosis and Risk Factors Flashcards

1
Q

Risk factors for thrombosis

A

Virchow’s triad- flow, composition or vessel wall

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2
Q

Outline the brief pathology of arterial thrombosis

A

Atherosclerosis, rupture of atheromatous plaque, endothelial injury, platelet aggregation

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3
Q

Describe the composition of thrombi in venous thrombosis

A

Pred. fibrin and RBCs, less platelets

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4
Q

Complication of venous thrombosis

A

Venous thromboembolism (VTE)

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5
Q

Treatment for VTE

A
Low molecular weight heparin e.g. fondaparinux
Newer anticoagulants e.g:
Xa inhibitors rivaroxaban
IIa inhibitors dabigatran
Compression stockings
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6
Q

Natural procoagulants

A

Clotting factors

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7
Q

Natural anticoagulants

A

Antithrombin III
Proteins C+S
Fibrinolytics

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8
Q

How does heparin work?

A

Increases antithrombin activity

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9
Q

Does LMWH predominantly target Xa or IIa?

A

Xa

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10
Q

Does fondaparinoux predominantly target Xa or IIa?

A

entirely Xa

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11
Q

Diagnostic test for VTE

A

Wells score
D-dimer test
Ultrasound
VQ scan

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12
Q

What test is used to measure the breakdown products of fibrin clots- specific to plasmin acting on fibrin

A

D-dimer

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13
Q

What does the VQ scan pick up in PE?

A

Ventilation:perfusion mismatch

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14
Q

What are the advantages of novel anticoagulants?

A

Dose is uniform for post patients and rapid onset

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15
Q

Target INR

A

2.5

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16
Q

Familial or acquired disorder of the haemostatic mechanism likely to predispose to thrombosis

A

Thrombophilias

17
Q

Heritable thrombophilias

A
Antithrombin def
Protein C def
Protein S def
FV leiden-activated protein C resistance
Prothrombin 20210A
Dysfibrinogenaemia
18
Q

Prothrombin 20210A

A

Too much prothrombin

19
Q

An example of an acquired thrombophilia

A

Antiphospholipid syndrome- autoimmune, hypercoagulable state

20
Q

Clinical features of thrombophilia

A

VTE
Superfical thrombophlebitis
Thrombosis of cerebral, axillary, portal and mesenteric veins
Coumarin induced skin necrosis (PC deficiency)
Obstetic complications- fetal wastage- thrombosis of placental circulation

21
Q

What is the function of protein C

A

Breaksdown Va and VIIIa

22
Q

What is the function of protein S

A

Cofactor for protein C

23
Q

Describe factor V leiden

A

Va resistant to protein C

24
Q

Examples of hypercoagulable state

A

FV leiden
Pill
Pregnancy
Immobility