Inherited and acquired Thrombotic disorders

Question 1

Symptoms of PE

Answer 1

SOB
Pleuritic chest pain
haemoptysis
haemodynamic instability

Question 2

symptoms of a DVT in the leg

Answer 2

calf swelling >3cm compared to other leg

Measured 10cm below tibial tuberosity

Collateral (nonvaricose) superficial veins present

Localized tenderness along the deep venous system

Pitting oedema, confined to symptomatic leg

Question 3

what is Virchow’s triad

Answer 3

endothelial injury
stasis
hypercoagulable state

Question 4

describe the process of haemostatic plug formation

Answer 4

Response to injury- Vessel constriction

Formation of unstable platelet plug

- platelet adhesion
- platelet aggregation

Fibrin stabilisation of the plug with fibrin
- blood coagulation

Dissolution of clot and vessel repair
- Fibrinolysis

Question 5

3 examples of inherited thrombophilias

Answer 5

Factor V Leiden
Prothrombin mutation
Protein C deficiency
Protein S deficiency
Antithrombin deficiency
High factor Vlll levels
Hyperhomocysteinaemia

Question 6

2 reasons young women are more likely than young men to get a thrombus

Answer 6

pregnancy

hormones

Question 7

4 causes of increased thrombosis in the elderly

Answer 7

Decreased mobility

Reduced muscular tone

Increasd frequency of risk-enhancing disease (eg. Malignancy)

Aging tissues: Vein walls and valves, Subcutaneous tissues

Question 8

5 examples of stasis causing thromboembolism

Answer 8

Prolonged immobility eg surgery, travel
Stroke
Cardiac failure
Pelvic obstruction
Dehydration
Hyperviscosity
Polycythaemia
Long haul flight

Question 9

Ix for thrombophilia

Answer 9

Inherited thrombophilia testing in lab
Direct assays
Protein C
Protein S
Antithrombin levels
Mutation analysis for prothrombin gene mutation and factor V Leiden