Flashcards in Haematology 8 - Thrombosis: aetiology and management Deck (28)
What is the triad of symptoms in thrombophlebitic syndrome?
What catalyses the conversion of fibrinogen to fibrin?
Which anticoagulant molecules are expressed on the blood vessel wall?
Endothelial Protein C receptor
How does inflammation affect the blood vessel wall?
It makes it prothrombotic
Recall 5 effects of inflammation on the blood vessel wall
1. Anticoagulant molecules are downregulated
2. TF expressed
3. Prostacyclin decreased
4. Adhesion molecules upregulated
5. VWF released (leading to neutrophil capture, and formation of NETs)
How do neutrophils contribute to immunothrombosis?
Neutrophils release DNA, which is procoagulant
What is the mechanism of action of clopidogrel?
Inhibits ADP receptors
Give 4 ways in which blood stasis promotes thrombosis
1. Accumulation of activated factors
2. Promotes platelet adhesion
3. Promotes leukocyte adhesion and transmigration
4. Hypoxia produces inflammatory effect on endothelium
What is the broad mechanism of action of heparins?
What is one risk of long term heparin use?
Give an example of an anti-Xa drug
Give an example of an anti-IIa drug
How does warfarin affect vit K?
Prevents recycling of Vit K
Which procoagulant factors fall as a result of warfarin medication?
II, VII, IX and X
Also Protein C and Protein S
How is warfarin monitored?
Why should warfarin never be given to pregnant women?
It is teratogenic
Give an example of an LMWH
What scoring system is used to calculate risk of thrombosis?
Which surgeries carry the highest risk of thrombosis?
Which surgeries carry highest risk of bleeding?
Neuro, spinal or eye surgery
Which class of anti-coagulants carries a significantly lower risk of intracranial bleeding?
What is the best drug to use as a long-term anticoagulant in a patient who has had an idiopathic VTE?
Recall 3 minor precipitants of thrombosis
After someone has suffered a thrombosis due to a minor precipitant, how long should they be anti-coagulated for?
Recall the order in which the different coagulation factors in the intrinsic pathway catalyse each other?
Which coagulation measure is used to monitor heparin therapy?
Which coagulation measure is used to monitor warfarin therapy?