Pathophysiology of Thrombosis Flashcards

1
Q

What is normal blood flow?

A

Laminar (smooth and ordered with cells in the middle)

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2
Q

What are the 2 kinds of abnormal blood flow?

A

Stasis

Turbulence

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3
Q

What is stasis blood flow?

A

Stagnation of flow, meaning blood flow slows down or stops

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4
Q

What is turbulence blood flow?

A

Forceful, unpredictable flow

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5
Q

What could defects in blood flow be due to?

A

Thromboembolism

Atheroma

Hyperviscocity

Spasm

External compression

Vasculitis

Vascular steal

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6
Q

What are the factors that cause thrombosis known as?

A

Virchow’s triad

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7
Q

What are the different components of Virchow’s Triad?

A

Changes in the blood vessel wall

Changes in the blood constituents

Changes in the pattern of blood flow

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8
Q

What is an example of changes in the blood vessel wall as part of Virchow’s triad?

A

Atheromatous coronary artery

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9
Q

What is an example of changes in blood constituents as part of Virchow’s triad?

A

Hyperviscocity

Post traumatic hypercoagulability

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10
Q

What is an example of changes in blood flow as part of Virchow’s triad?

A

Stasis or turbulence

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11
Q

What is thrombosis?

A

Formation of a solid mass from the constituents of blood within the vascular system during life

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12
Q

What is the formation of a solid mass from the constituents of blood within the vascular system during life called?

A

Thrombosis

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13
Q

What can a thrombus easily be confused with?

A

Blood clot - they are two different things

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14
Q

What is the pathogenesis of thrombosis?

A

1) Turbulent blood flow (fibrin deposition, platelet clumping)
2) Loss of intimal cells, denuded plaque
3) Collagen exposed, platelets adhere
4) Fibrin meshwork, red blood cells trapped
5) Alternating bands (lines of Zahn)
6) Further turbulence and platelet deposition
7) Propagation
8) Consequences

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15
Q

What commonly leads to thrombus?

A

Hypercholesteroaemia

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16
Q

What is the relationship between atheroma and thrombosis?

A

Arterial thrombosis is usually laid over an atheroma

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17
Q

What does the consequences of a thrombus depend on?

A

Site

Extend

Collateral circulation

18
Q

What are some common clinical scenarioes of thrombosis?

A

Deep vein thrombosis

Ischaemic limb

Myocardial infarction

19
Q

What are the potential outcomes of thrombosis?

A

Resolution

Organisation

Death

Propagation (turns to embolism)

20
Q

What is an embolism?

A

Movement of abnormal material in the bloodstream and its impaction in a vessel (blocking the lumen)

21
Q

What is the movement of abnormal material in the bloodstream and its impaction in a vessel (blocking the lumen) called?

A

Embolism

22
Q

What are most emboli?

A

Dislodged thrombi (thromboembolism)

23
Q

What do factors causing the embolism depend on?

A

Type of embolism

24
Q

What are different types of embolism?

A

Thrombus

Fat

Gas

Tumour

Trophoblast

Septic material

Amniotic fluid

Bone marrow

Foreign bodies

25
Q

What are the two different kinds of embolism caused by thrombus?

A

Systemic/arterial thromboembolism

Venous thromboembolism

26
Q

Where do aortic embolisms travel to?

A

Wide variety of sites, lower limbs being most common, could go to the brain

27
Q

What do consequences of arterial thromboembolism depend on?

A

Vulnerability of affected tissues to ischaemia

Calibre of occluded vessel

28
Q

Where do venous thromboembolisms originate from?

A

Deep venous thrombosis (lower limbs)

29
Q

Where do venous thromboembolisms travel to?

A

Pulmonary arterial circulation

30
Q

What do consequences of venous thromboembolism depend on?

A

Size of embolus

31
Q

What could the consequences of venous thromboembolism be?

A

Silent

Pilmonary haemorrhage/infarction

Right heart failur

Sudden death

32
Q

What does multiple pulmonary embolism over time lead to?

A

Pulmonary hypertension and right ventricular failure

33
Q

What are examples of gas embolism?

A

Decompression sickness (N2 forms as bubbles which lodge in capillaries)

Air embolus

34
Q

What is a trophoblast?

A

Cells forming the outer layer of a blastocyst

35
Q

What are the cells forming the outer layer of a blastocyst called?

A

Trophoblast

36
Q

What is infarction?

A

Obstruction of the blood supply to an organ causing local death of the tissue

37
Q

What is obstruction of the blood supply to an organ causing local death to the tissue called?

A

Infarction

38
Q

What are some risk factors for deep vein thrombosis and pulmonary embolism?

A

Cardiac failure

Severe trauma/burns

Post operation

Nephrotic syndrome

Disseminated malignancy

Oral contraceptives

Increasing age

Bed rest/immobilisation

Obesity

Past medical history of deep vein thrombosis

39
Q

What is used as prophylaxis for surgical patients at risk of deep vein thrombosis?

A

TEDS

S/C heparin

40
Q

What is prophylaxis?

A

Treatment or action to prevent disease

41
Q

What is treatment or action to prevent disease called?

A

Prophylaxis