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MoD > haemostasis and thrombosis > Flashcards

haemostasis and thrombosis Flashcards

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1
Q

What pathway does activated partial thromboplastin time (APTT) involve?

A

intrinsic

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2
Q

How can disorders of coagulation and haemostasis arise

A

Inherited-single gene mutations
acquired

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3
Q

How can platelets be affected

A

bnormal number of platelets
Abnormal function of platelets
Or both

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4
Q

What pathway does prothrombin time (PT) involve?

A

extrinsic

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5
Q

In what direction does thrombosis progress in veins

A

proximally

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6
Q

In what direction does thrombosis spread in arteries

A

distally

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7
Q

What 2 clotting screening tests are there

A

prothrombin time (PT)

Activated partial thromboplastin time (APTT)

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8
Q

What 2 genetically determined conditions increase risk of thrombosis

A

Factor V Leiden

Protein C deficiency

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9
Q

What activates Inactive FXIII

A

Thrombin IIa

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10
Q

What are DVT and PE collectively known as

A

Venous thromboembolism(VTE)

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11
Q

What are lines of Zahn

A

characteristic of thrombi that appear particularly when formed in the heart or aorta

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12
Q

What are some characteristics of arterial thrombi

A

Pale/red
granular
lines of Zahn

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13
Q

What are some examples of direct Xa inhibitors

A

Rivaroxaban
apixaban
edoxaban

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14
Q

What are some mechanical methods to prevent deep vein thrombosis - DVT

A

Anti-embolism stockings
intermittent pneumatic compression
foot impulse devices

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15
Q

What are some risk factors for arterial thrombosis(8)

A

Age
smoking
obesity
hypertension
atherosclerosis
diabetes
south asian
hypercholesterolaemia

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16
Q

What are some risk factors for VTE (Venous thromboembolism)(5)

A

age
malignancy
trauma
pregnancy
immobility

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17
Q

What are the 2 types of thrombosis

A

arterial and venous

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18
Q

What are the 3 classes of fibrinolytic drugs

A

Tissue plasminogen activator (t-PA)
Streptokinase
urokinase

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19
Q

What are the 3 components of virchow’s triad

A

Endothelial injury
hypercoagulability
stasis (pooling) of blood flow

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20
Q

What are the 3 stages of haemostasis

A

Primary haemostasis
secondary haemostasis
dissolution of clot and vessel repair (fibrinolysis)

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21
Q

What are the 4 core components of haemostasis

A

Vessel wall
platelets
coagulation system
fibrinolytic system

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22
Q

What are the most common thrombosis disorders

A

Deep vein thrombosis (DVT)
Pulmonary embolism(PE)

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23
Q

What are the different blood tests that can be done for haemostasis

A

full blood count
prothrombin time(PT)
activated partial thromboplastin time(APTT)

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24
Q

What are the different severities of pulmonary embolisms

A

Massive PE
major PE
Minor PE

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25
What are the different types of embolism that can occur
Air Nitrogen fat amniotic fluid (only in pregnancies)
26
What are the effects of arterial thrombosis
Ischaemia and infarction
27
What are the effects of venous thrombosis
Congestion oedema haemorrhage
28
What are the most common type of emboli
thrombo-emboli
29
What are the problems with warfarin
Need monitoring of INR with frequent blood tests Dose sensitive
30
What can inhibit tissue factor in extrinsic coagulation pathway
Tissue factor pathway inhibitor
31
What clotting cascade affected in haemophilia
Intrinsic pathway
32
What coagulation inhibititors do endothelial cells produce
NO (nitric oxide) Prostacyclin
33
what condition can arise from recurrent minor Pulmonary embolism
pulmonary hypertension
34
What do endothelial cells secrete in blood vessel wall injury
Von Willebrand factors
35
What does activated partial thromboplastin time measure
Instrinsic pathway
36
What does antithrombin III inhibit
Thrombin and FXa
37
What does the prothrombin time test measure
Extrinsic clotting pathway
38
What factors are cleaved by Protein C
Factor Va and VIIIa
39
What is a embolism
Blockage of a blood vessel by a solid,liquid or gas at a site distant from its origin
40
What is a major pulmonary embolism
Medium sized vessels blocked
41
What is a minor Pulmonary embolism
Small peripheral pulmonary arteries blocked
42
What is an example of a direct thrombin inhibitor
Dabigatran
43
What is DIC (disseminated intravascular coagulation)
Blood clots form throughout the body blocking small blood vessels
44
What is haemarthrosis
condition that arises due to bleed into joint cavity
45
What is included in the balance in haemostasis
Procoagulant factors anticoagulant factors
46
What is leukocytosis
white blood cell count is above normal range in blood, is a sign of inflammatory response
47
What is massive pulmonary embolism
60% reduction in blood flow due to embolism
48
What is primary haemostasis
Formation of unstable platelet plug
49
what is pulmonary thromboembolism
blood clot lodged in artery in lung hence blocking blood flow to part of lung
50
What is sagittal sinus thrombosis
presence of blood clot in dural venous sinuses
51
what is secondary haemostasis
stabilisation of plug with fibrin in blood coagulation system
52
What is the characteristic of thrombosis of the femoral artery
White bloodless limb
53
what is the D-Dimer test
Blood test that can be used to diagnose thrombosis by measuring levels of D-Dimer in the blood
54
What is the function of warfarin
Inhibit hepatic synthesis of Factor II,VII,IX and X It is a vitamin K antagonist hence inhibit production of Vitamin K dependant clotting factors
55
What is the process of platelet plug formation
Platelets adhere to subendothelial structures via von Willebrand factors platelets adhere to one another and the plug is held by insoluble fibrin
56
What is the Well’s Score ?
Scoring system that assesses probability of PE with given presentations
57
What is the Well’s Score ?
Scoring system that assesses probability of PE with given presentations
58
What is thrombophilia
Imbalance in blood clotting proteins or clotting factors
59
what is thrombosis
Formation of a solid mass of blood clot within circulatory system
60
What is treatment for classic Haemophillia
Recombinant FVIII
61
What is treatment for VTE
IV heparin warfarin direct oral anticoagulants
62
What is Virchow's triad
three broad categories of factors that contribute to thrombosis
63
What occurs in DIC(Disseminated intravascular coagulation)
clotting cascade accelerated clotting factors consumed faster than they can be replaced
64
What occurs in lysis stage of thrombosis
Complete dissolution of thrombus fibrinolytic systems become active
65
What occurs in organisation stage of thrombosis
Growth of fibroblasts and capillary proliferation
66
What occurs in propagation stage of thrombosis
Progressive spread of thrombosis
67
What occurs in recanalisation stage of thrombosis
One or more channels form through the thrombus blood flow becomes re-established
68
What occurs in thrombotic thrombocytopaenic purpura
Platelet masses form in small vessels leading to a haemorrage and purpura
69
What scoring system used to assess probability of DVT
Wells score
70
Where can a embolism from aorta travel to
Renal mesenteric
71
Where can an embolism from carotid arteries travel to
brain
72
Where can embolism of abdominal aorta travel to
Legs
73
where does purpuric (small blood vessels) bleeding occur
kidney skin brain gut heart
74
Why do we need anti-thrombotics
Prevent arteries and capillaries being constantly blocked Inhibit strokes and heart attacks

MoD (8 decks)

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