Pathology - Thrombosis, Embolism and Infarction

Question 1

What is Virchow’s Triad?

Answer 1

Site of endothelial injury
Trubulent blood flow
Hypercoaguable blood. Slide 8

Question 2

What happens during platelet activation?

Answer 2

The platelets are more ‘sticky’ and aggregate with other platelets. Slide 9

Question 3

What happens when endothelium is lost and the underlying collagen is exposed?

Answer 3

Collagen binds to glycoproteins Ia/IIb on the platelets as well as von Willebrands Factor.
There is ian increase in platelet integrins.
Glycoproteins IIb/IIIa binds to fibrinogen and the activated paltelets release granules to attract others. Slide 10

Question 4

What is the test to assess how good the intrinsic pathway is for coagulation?

Answer 4

Prothrombin Time (PTT) Slide 14

Question 5

What does the intrinsic pathway for coagulation start with?

Answer 5

Hageman factor (FXII) and kalikrien. Slide 14

Question 6

What is the test to assess how good the extrinsic pathway is for coagulation?

Answer 6

Activated Partial Thromboplastin Time (APTT). Slide 15

Question 7

Do the intrinsic and extrinsic ever have a common pathway in the coagulation cascade?

Answer 7

Yes. Slide 13

Question 8

Why is vitamin K so important in the diet?

Answer 8

As it makes factors II, VII, IX and X which all take part in the coagulation cascade. Slide 18

Question 9

What does warfarin do?

Answer 9

Stops production of II, VII, IX and X which reduces the coagulation cascade. Slide 18

Question 10

What are complications of thrombosis?

Answer 10

Exercise induced angina - stable

Plaque rupture - unstable. Slide 24

Question 11

What does turbulence cause?

Answer 11

Swirling of blood and endothelial cell injury and stasis. Slide 29

Question 12

What can cause hypercoaguability?

Answer 12

Dehydration
Polycythemia
Leukaemia.

Factor V Lieden disorder
Protein C and S deficiency.
Slide 33+38

Question 13

What are some anti-clotting proteins?

Answer 13

Protein C, protien S and antithrombin III. Slide 34

Question 14

What are secondary causes of thrombis?

Answer 14

Significant tissue injury 
MI
AF
Cancer - activate cascade
Therapy - chemo
Marantic endocarditis
The pill
Smoking
Slide 35-37

Question 15

Where do thrombus especially occur in blood vessels?

Answer 15

Branching vessels
- Coronary vessels
- Above bifurcation of aorta
- Renal arteris
- Superior Mesenteric Artery
Slide 40

Question 16

What are possible emboli?

Answer 16

Air
Septic (pus)
Amniotic fluid
Tumour
Fat. Slide 45

Question 17

How do cells actually die due to infarction?

Answer 17

There is increased influx of Ca which stimulates:
ATPase
Phospholipase
Proteases
Endonuclease
Mitochondrial permeability (released pro death factors). Slide 47