Thrombosis

Question 1

Thrombus thrombosis

Answer 1

Solidification of blood contents forms within vascular system during life

Thrombosis is how it is formed

Question 2

What can cause thrombosis

Answer 2

Virchows triad

Abnormal blood flow
Hypercoagulability
Endothelial injury

Question 3

Endothelial injury

Answer 3

Formation thrombi in heart and arteries

At sites of MI
ulcerated plaques in atherosclerosis
Injured endocardium
Valves with inflammatory valve disease and prosthetic valves

Radiation chemical bacteria immunological do plastic

Question 4

Platelets role

Answer 4

Platelet undergo 3 important reactions after injury

Adhesion
Secretion
Aggregation

Question 5

Pathogenesis endothelial injury

Answer 5

Vasoconstriction - endothelin

Hemostasis - ADP, TXA, Pf4, vWF
Platelets adhesion 
Shape change
Granule release ADO TXA2
Recruitment 
Aggregation 

Secondary hemostasis
Tissue factor, release of phospholipid complex expression, thrombin activation, fibrin polymerisation

Thrombus and antithrombotix events
Release tPA and thrombomodulin
Trapped blood cells and neutrophils

Question 6

Deficiency of Gpllblla

Answer 6

Glanzmanns theombasthenia

Question 7

Defiency od Gplb

Answer 7

Bernard doilies syndrome

Question 8

Deficiency of Von willebrand factoe

Answer 8

Von willbrand disease

Question 9

Alterations in normal blood flow

Answer 9

Tuberulence contributes to development of arterial and cardiac thrombi

Stasis contributes to venous thrombosis

Question 10

Turbulence and stasis

Answer 10

Disrupt laminar flow
Prevent dilution of coagulation factors
Stop clotting factor inhibitors
Promote endothelial cell activation

Question 11

Hypercoagulability

Answer 11

Alteration of blood coagulation mechanism which predisposes thrombosis

Primary genetic - mutation v gene leiden mutation, antithrombin deficieny lll, protein c and sndeficiency

Secondary acquired - high risk bed rest immobilisation, tissue damage prosthetic valves DIC smoking sickle cell anaemia

Question 12

Morphology of thrombi

Answer 12

Mural thrombi
Arterial thrombi
Venous thrombosis

Question 13

Mural thrombi

Answer 13

Applied to one wall of underlying structure

Occurs in capacious lumina of Heart chambers and aorta

Question 14

Arterial thrombosis

Answer 14

In coronary arteries, cerebral and femoral arteries

Question 15

Thrombi hydrology

Answer 15

Laminations called lines of Zahn
Pale band is fibrin and platelets
Red band is RBCs

Question 16

Venous thrombosis

Answer 16

Occlusive dark red
Affect veins of lower legs 90
Deep calf femoral popliteal iliac veins

Thrombophlebitis- inflamed and thrombosis

Question 17

Fate of thrombus

Answer 17

Resolution
Lungs
Organised and incorporated into wall
Organised and recanalisdd

Question 18

Arterial thrombosis

Answer 18

Loss of pulses distal to thrombus
Area is cold pale painful oaraesthesia
Tissue dies and gangrene

Question 19

Venous thrombosis can be

Answer 19

Superficial saphenouscongrstion swelling pain tender (rarely embolise)

Deep foot and ankle odemea
Homans sign
Asymptomatic

Question 20

Treatment

Answer 20

Stockings
Anticoagulant drugs

Herpain IV and warfarin ORAL

Question 21

Embolus

Answer 21

Detached solid that is carried by blood to distant site

90% all emoji arise in thrombus

Question 22

Embolism

Answer 22

Bone bone marrow
Atheromatus debris
Droplets of fat 
Tumor
Foreign bodies bullet
Sbublles of air nitrogen

Question 23

Pulmonary embolism

Answer 23

Occlusion of large pulmaonry artery

95 due to thrombinin veins of lower leg

May impact main pulmonary artery or lodge at bifurcation as saddle emobilus

Question 24

Consequences of pulmonary embolism

Answer 24

Respiratory compromise
Haemodynamic comprosmise

LARGE PENinstatenous death
Pulseless electrical activity PEA

Question 25

Smaller pe cause

Answer 25

Acute respiratory and cardiac problems

Question 26

Systemic embolism

Answer 26

through arterial circulation Arise form thrombi in heart Ulcerated atherosclerotic plaque Aortic aneurysm Infective endocarditis Valvular or aortic prosthesis Cause infarction Lower extremities, brain, viscera, upper limbs

Question 27

Air embolism

Answer 27

Bubbles in circulation obstruct vascular flow and damage tissues Barotruma Delivery or abortion Pneumothorax Injury chest wall Caisson disease or decompression sickness

Question 28

What's caisson diseas

Answer 28

Scuba deep sea workers in underwater individual decompressed too rapidly, helium and nitrogen form gaseous emboli

Question 29

Treatment for caisson disease

Answer 29

Decompression chamber

Question 30

Fat embolism

Answer 30

Minute globules of fat - fracture of shafts and soft tissue trauma Fat embolism syndrome

Question 31

Fat embolism pathogenesis

Answer 31

Mechanical - microagreagtes of neutral fat cause occlusion Chemical - free fatty acids release from fat globules result in toxic injury to vascular endothelium

Question 32

Detecting dat embolism

Answer 32

Pulmonary insufficnxy Neurological symptoms Anaemia and thrombocytopenia Latent after 24/72 hrs

Question 33

Amniotic fluid embolism

Answer 33

Rare labour maternal mortality 86% Caused by infusion of amniotic fluid into maternal circulation Respiratory difficulty Convulsions Coma

Question 34

Infarct

Answer 34

Area of ishcaemic necrosis caused by occlusion of arterial supply or venous drainage of tissue

Question 35

Causes of infarcts

Answer 35

99% Thrombosis Embolism

Question 36

Types of infarcts

Answer 36

Red haemorrhagic Venous occlusion in loos tissues and in tissue wth dual circulation White anaemia Arterial occlusion in solid organs Septic or bland

Question 37

Infarcts in ovary

Answer 37

Venous occlusion dark blue and haemorhiagic

Question 38

Lung infarction

Answer 38

Loose tissue wedge red and haemorjiax

Question 39

Small intestine infarct

Answer 39

Dual circulation | Red and haemorrhagic

Question 40

Histology of infarction

Answer 40

Ischaemic coagulative necrosis mins to days (liquefaction in CNS) Inflammation response house - 7 days Reparative response (1-2 wks) Scaring (2wks to 2 months)