Atherosclerosis, Thrombosis, Embolism Flashcards Preview

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Flashcards in Atherosclerosis, Thrombosis, Embolism Deck (29):
1

Define 'thrombosis'

Formation of a mass (thrombus) from the constituents of blood within the vasculature during life

2

How does a thrombus differ from a clot?

Thrombus must form during life in the body; clots can form when blood is extracted post-mortem

3

What are the 3 components of Virchow's triad?

Changes in blood flow
Changes in blood coagulability
Endothelial damage

4

Give some examples of hypercoaguable aquired states

Myocardial infarction
Immobility
Cancer
Prosthesis
AF
Cardiomyopathy
Oral contraceptive use

5

Arterial thrombi are red. True/False?

False

6

Where do arterial thrombi often lodge?

Coronary, cerebral, femoral circulations

7

Define 'embolism'

Detached intravascular solid/liquid/gas mass carried distal to point of origin

8

Venous emboli commonly infarct peripheral circulation. True/False?

False
Very rare (carried to pul circulation, more likely lodge there)

9

Give examples of factors causing endothelial injury

Smoking
Hyperlipidaemia
Hypertension
Toxins
Infection

10

Give examples of what happens due to endothelial dysfunction

Increased permeability
Macrophage + platelet adhesion and activation

11

Once macrophages are activated on the endothelial surface, what do they generate?

Oxidative free radicals
Cytokines

12

What do oxygen free radicals do to LDL?

Ingest and trap it within macrophages, forming foam cells/fatty streaks

13

In a pre-test probability (PTP) score for DVT, the scoring does not apply in what situations?

If you have had a previous DVT
If you are pregnant

14

A PTP score for DVT of 3 or more is high risk. True/False?

True

15

D-dimer can both rule out and diagnose DVT. True/False?

False

16

What is D-dimer?

A breakdown product of fibrin

17

If D-dimer levels are low, a DVT is unlikely. True/False?

True

18

If D-dimer levels are high, a DVT is very likely. True/False?

False
D-dimer levels are raised by many things (infection, MI, surgery)

19

If your PTP score is low and D-dimers are low, a DVT can be excluded. True/False?

True

20

If your PTP score is low and D-dimers elevated, what is the next investigation for diagnosing a DVT?

(Doppler) ultrasound

21

If your PTP score is high and D-dimers low and US negative, DVT can be excluded. True/False?

True

22

If your PTP score is high and D-dimers high but US negative, DVT can be excluded. True/False?

False
Repeat US before completely excluding DVT

23

What is the mainstay of DVT treatment?

Anticoagulation (LMWH heparin, warfarin)
TED compression stockings

24

What is phlegmasia dolens?

DVT causes obstruction of arterial flow due to back pressure created

25

How is phlegmasia dolens usually treated?

IVC filter through femoral artery which prevents thrombus entering lungs

26

What is the first line imaging modality of choice for PE?

V/Q scan

27

What is the advantage of a caval filter for acute PE?

Prevents recurrence of PE in short term

28

What is the drawback of a caval filter?

Increases risk of DVT - patients will require anticoagulation if long-term filter

29

When is warfarin contraindicated?

Pregnancy
Increased haemorrhage risk (uncontrolled drug abuse, dementia etc.)