Pathophysiology of thrombosis & embolism

Question 1

what is embolism

Answer 1

an obstruction of an artery, typically by a clot of blood or air bubble

Question 2

state 4 factors causing embolism

Answer 2

high blood pressure
atherosclerosis
high cholesterol
thrombosis

Question 3

what is thrombosis

Answer 3

local coagulation in a part of the circulatory system

Question 4

describe thrombosis

Answer 4

clotting of the blood in a part of the circulatory system

Question 5

describe the process of thrombosis

Answer 5

it is the process of a blood clot forming in a blood vessel, this blood clot can be described as a thrombus

Question 6

what is a thrombus

Answer 6

it is a blood clot formed in situ within the vascular system of the body and impedes blood flow

Question 7

what is the result of a clot formed in a blood vessel in thrombosis

Answer 7

this clot can block or obstruct blood flow in the affected area, as well as cause serious complications if the clot moves to a crucial part of the circulatory system, such as the brain or the lungs

Question 8

what does Virchow’s triad describe

Answer 8

3 broad categories of factors that are though to contribute to thrombosis

Question 9

what are the 3 broad categories of Virchow’s triad that are thought to contribute to thrombosis

Answer 9

the states of blood flow
endothelial injury
hyper-coagubility

Question 10

what is atheroma

Answer 10

the fatty material which forms deposits in the arteries

Question 11

state a genetic condition which is a factor causing thrombosis

Answer 11

thrombophilia, this is a genetic condition where your blood has an increased tendency to clot

Question 12

state an immune system disorder that is a factor causing thrombosis

Answer 12

anti-phospholipid syndrome is an immune system disorder that causes an increased risk of blood clots

Question 13

what are factors causing thrombosis

Answer 13

infectious and inflammatory conditions

Question 14

state an infectious condition that is a factor causing thrombosis

Answer 14

hepatitis

Question 15

state an inflammatory condition that is a factor causing thrombosis

Answer 15

rheumatoid arthritis

Question 16

what is normal blood flow

Answer 16

LAMINAR

Question 17

what is abnormal blood flow

Answer 17

STASIS: stagnation of flow
TURBULENCE: forceful, unpredictable flow

Question 18

what are defects in blood flow

Answer 18

thromboembolism
atheroma
hyper viscosity
spasm
external compression
vasculitis
vascular steal

Question 19

what is Virchow’s triad

Answer 19

changes in the:
blood vessel wall
blood constituents
pattern of blood flow

Question 20

what are the factors causing thrombosis

Answer 20

Virchow’s triad

Question 21

define thrombosis

Answer 21

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

Question 22

what do the consequences of thrombosis depend on

Answer 22

site
extent
collateral circulation

Question 23

what are common clinical scenarios from presenting with thrombosis

Answer 23

deep vein thrombosis
ischaemic limb
myocardial infarction

Question 24

what is the outcome of thrombosis

Answer 24

resolution
organisation/recanalisation
death
propagation leading to embolism

Question 25

what is embolism

Answer 25

the movement of abnormal material in the bloodstream and its impaction in a vessel, blocking the lumen

Question 26

what is a embolus

Answer 26

it is a detached intravascular solid, liquid or gaseous mass

Question 27

what are most emboli

Answer 27

dislodged thrombi

Question 28

what do factors causing embolism depend on

Answer 28

the type of embolus

Question 29

what are types of thrombus embolus

Answer 29

systemic thromboembolus | and arterial thromboembolus

Question 30

describe systemic thromboembolus

Answer 30

embolus that travels to a wide variety of sites, from the lower limbs commonly, to the brain and other organs

Question 31

what do the consequences fro a systemic thromboembolus depend on

Answer 31

vulnerability of affected tissues to ischaemia, calibre of occluded vessel, collateral circulation but usually infarction occurs

Question 32

describe a venous thromboembolus, a type of embolus

Answer 32

this thrombus originates from deep venous thromboses (lower limbs)

Question 33

what are risk factors for deep vein thrombosis and pulmonary thromboembolism

Answer 33

``` cardiac failure severe trauma burns post-op post-partum nephrotic syndrome disseminated malignancy oral contraceptive older age bed rest immobilisation obesity past medical history of deep vein thrombosis ```

Question 34

what is affected from a syndrome of fat embolism

Answer 34

brain kidneys skin

Question 35

when do fat embolus occur

Answer 35

after major fractures

Question 36

when do air embolus occur

Answer 36

head wounds neck wounds surgery CV lines

Question 37

what is amniotic fluid embolus the cause

Answer 37

collapse in childbirth

Question 38

when are bone marrow embolus present

Answer 38

fractures | CPR

Question 39

when is a foreign body embolus present

Answer 39

intravascular cannula tips sutures etc.

Question 40

what are presenting features of rheumatic fever

Answer 40

flitting polyarthritis of large joints skin rashes fever i.e. painful wrists, elbows, knees, ankles

Question 41

who does rheumatic fever commonly affect

Answer 41

children aged 5-15 years | boys more than girls

Question 42

where is rheumatic fever common

Answer 42

india, middle east, central Africa

Question 43

where is rheumatic fever now rare

Answer 43

in Europe and north America

Question 44

what is rheumatic fever

Answer 44

it is a disease of disordered immunity, it is inflammatory changes in the heart and joints

Question 45

when aschoff body seen?

Answer 45

in the heart in acute rheumatic fever

Question 46

what is an aschoff body

Answer 46

it is a focus of chronic inflammatory cells, necrosis and activated macrophages

Question 47

what pathological problems result from valvular heart disease

Answer 47

valvular stenosis valvular incompetence valvular regurgitation vegetations

Question 48

what is virtually the only cause of mitral stenosis

Answer 48

rheumatic heart disease

Question 49

what can cause mitral regurgitation, which is however most often due to ischaemic heart disease

Answer 49

rheumatic heart disease

Question 50

what now only rarely causes aortic stenosis

Answer 50

rheumatic heart disease

Question 51

what is aortic stenosis mostly due to

Answer 51

calcific aortic valve disease