Hemodynamics Part II: thrombosis Flashcards Preview

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Flashcards in Hemodynamics Part II: thrombosis Deck (21):
1

components of virchow's triangle

hypercoagulable state
circulatory stasis
endothelial injury

all lead to thrombosis

2

dominant influence on thrombosis

enothelial injury

especially important in thrombus formation in heart and arterial circulation

3

factor V leiden mutation

hypercoagulable state

glutamine substitutes for arginine at position 506 of factor V protein

causes resistance to degradation by activated prtn C ---> increased probability of thrombosis

4

prolonged bedrest or immobilization ---.

high risk for thrombosis

5

antiphospholipid antibody syndrome

serum antibodies directed against anionic phospholipids

causes hypercoagulable state in vivo (inhibit clotting in vitro)

associated with lupus

observe: recurrent venous or arterial thrombi, repeated miscarriages, cardiac valve vegetations, thrombocytopenia

6

disruption of normal laminar flow

turbulence

forms countercurrents causing local pockets of stasis which prevents dilution of clotting factors, prevents inflow of clotting inhibitors and promotes endothelial cell activation

7

growth promoting agents

angiotensin II
endothelin 1
platelet derived growth factor

8

growth inhibiting agents

NO
TGF-beta

9

prothrombotic agents

MCP-1
VCAM-1`

10

antithrombotic agents

NO
prostacyclin
tissue plasminogen activator
thrombomodulin

11

sites of endothelial injury -->

arterial thrombi

12

consequence of stasis --->

venous thrombi

13

thrombi have a point of _________ attachment to the vessel

firm

14

risk factors for arterial thrombosis

MI
rheumatic heart disease
atrial fibrillation
atherosclerosis

15

incidence of arterial thrombi

coronary artery > cerebral artery > femoral artery

16

what is an areterial thrombi composed of?

platelets
fibrin
erythrocyte
leukocyte

17

when is stenting or surgery recommended for aneurysms?

greater than 5cm in diametere

18

what are lines of zahn in a thrombus

alternate layering of platelets, fibrin and erythrocytes

19

aka phlebothrombosis

venous thrombosis

20

where do venous thrombosis most commonly occur?

in legs (deep veins especially)

21

how is cancer a risk factor for venous thrombosis/

trousseau syndrome/ migratory thrombophlebitis

a serine protease released by malignant tumor cells activates factor 10

tumor cells release vesicle with procoagulant activty. tissue thromboplastin is released from necrotic tumor