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MD2002 > Thrombosis > Flashcards

Thrombosis Flashcards

1
Q

Thrombus thrombosis

A

Solidification of blood contents forms within vascular system during life

Thrombosis is how it is formed

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2
Q

What can cause thrombosis

A

Virchows triad

Abnormal blood flow
Hypercoagulability
Endothelial injury

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3
Q

Endothelial injury

A

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

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4
Q

Platelets role

A

Platelet undergo 3 important reactions after injury

Adhesion
Secretion
Aggregation

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5
Q

Pathogenesis endothelial injury

A

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

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6
Q

Deficiency of Gpllblla

A

Glanzmanns theombasthenia

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7
Q

Defiency od Gplb

A

Bernard doilies syndrome

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8
Q

Deficiency of Von willebrand factoe

A

Von willbrand disease

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9
Q

Alterations in normal blood flow

A

Tuberulence contributes to development of arterial and cardiac thrombi

Stasis contributes to venous thrombosis

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10
Q

Turbulence and stasis

A

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

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11
Q

Hypercoagulability

A

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

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12
Q

Morphology of thrombi

A

Mural thrombi
Arterial thrombi
Venous thrombosis

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13
Q

Mural thrombi

A

Applied to one wall of underlying structure

Occurs in capacious lumina of Heart chambers and aorta

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14
Q

Arterial thrombosis

A

In coronary arteries, cerebral and femoral arteries

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15
Q

Thrombi hydrology

A

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

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16
Q

Venous thrombosis

A

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

Thrombophlebitis- inflamed and thrombosis

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17
Q

Fate of thrombus

A

Resolution
Lungs
Organised and incorporated into wall
Organised and recanalisdd

18
Q

Arterial thrombosis

A

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

19
Q

Venous thrombosis can be

A

Superficial saphenouscongrstion swelling pain tender (rarely embolise)

Deep foot and ankle odemea
Homans sign
Asymptomatic

20
Q

Treatment

A

Stockings
Anticoagulant drugs

Herpain IV and warfarin ORAL

21
Q

Embolus

A

Detached solid that is carried by blood to distant site

90% all emoji arise in thrombus

22
Q

Embolism

A 
Bone bone marrow
Atheromatus debris
Droplets of fat 
Tumor
Foreign bodies bullet
Sbublles of air nitrogen
23
Q

Pulmonary embolism

A

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

24
Q

Consequences of pulmonary embolism

A

Respiratory compromise
Haemodynamic comprosmise

LARGE PENinstatenous death
Pulseless electrical activity PEA

25
Q

Smaller pe cause

A

Acute respiratory and cardiac problems

26
Q

Systemic embolism

A

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

27
Q

Air embolism

A

Bubbles in circulation obstruct vascular flow and damage tissues

Barotruma

Delivery or abortion
Pneumothorax
Injury chest wall
Caisson disease or decompression sickness

28
Q

What’s caisson diseas

A

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

29
Q

Treatment for caisson disease

A

Decompression chamber

30
Q

Fat embolism

A

Minute globules of fat - fracture of shafts and soft tissue trauma

Fat embolism syndrome

31
Q

Fat embolism pathogenesis

A

Mechanical - microagreagtes of neutral fat cause occlusion

Chemical - free fatty acids release from fat globules result in toxic injury to vascular endothelium

32
Q

Detecting dat embolism

A

Pulmonary insufficnxy
Neurological symptoms
Anaemia and thrombocytopenia

Latent after 24/72 hrs

33
Q

Amniotic fluid embolism

A

Rare labour maternal mortality 86%

Caused by infusion of amniotic fluid into maternal circulation

Respiratory difficulty
Convulsions
Coma

34
Q

Infarct

A

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

35
Q

Causes of infarcts

A

99%

Thrombosis
Embolism

36
Q

Types of infarcts

A

Red haemorrhagic
Venous occlusion in loos tissues and in tissue wth dual circulation

White anaemia
Arterial occlusion in solid organs

Septic or bland

37
Q

Infarcts in ovary

A

Venous occlusion dark blue and haemorhiagic

38
Q

Lung infarction

A

Loose tissue wedge red and haemorjiax

39
Q

Small intestine infarct

A

Dual circulation

Red and haemorrhagic

40
Q

Histology of infarction

A

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

MD2002 (22 decks)

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