Thrombosis

Question 1

What is it?

Answer 1

The development of a clot in the systemic or pulmonary circulation which interrupts blood flow

Question 2

Causes

Answer 2

Virchow’s triad:
1-Changes in blood vessels wall:
-endothelium injury
-Endothelium disruption
resultant from infection, chronic inflammation, toxins
2-Changes in blood constituents:
hypercoagulability,
hyper viscosity
Resultant from: genetics, surgery, medication
3- changes in pattern of flow:
turbulent
Stagnant
Resultant from skeletal muscle dysfunction
ateromatous plaque, aortic aneurysm, post op., economy class syndrome, bed rest, pregnancy

Question 3

How does it develop?

Answer 3

Turbulent blood flow causes loss of intimal cells= denuded plate
Tissue factor is released- factor 5 causes the breakdown of prothrombin to thrombin
Thrombin causes the breakdown of fibrinogen to cross linked fibrin
Collagen becomes exposed so platelets adhere
Platelet plug
Coagulation cascade
RBCs become trapped in fibrin meshwork= bands of Zahn
Further turbulence and platelet deposition

Question 4

Treatment

Answer 4

own by themselves

• Thrombolytic enzymes
• Thrombolysis

Preventative:
-anticoagulants: 
parental: -LMW/unfractionated heparin
Enteric: warfarin 
-IVC filter to prevent DVT
-compression stockings 
-calf exercises

Question 5

Different types of thrombi?

Answer 5

Arterial thrombus

Venous thrombus

Question 6

Arterial thrombus characteristics

Answer 6

cause: atherosclerotic rupture
what does it cause: ischaemia and infarction , ACS, claudication
What is the clot made up of: fibrin and platelets
colour of the thrombus: white
Location: Left chambers of the heart, arteries

Question 7

Venous thrombus characteristics

Answer 7

location: venous valves
causes: Virchow’s triad
What can it lead to: Back flow of blood
Composition of clot: fibrin+ red blood cells
colour of clot: Red