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Thrombosis Flashcards

(54 cards)

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1
Q

What does coagulation prevent?

A

Prevents blood loss

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2
Q

What does inflammation activate?

A

Inflammation activates coagulation and coagulation promotes inflammation

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3
Q

What type of response is coagulation?

A

Coagulation is an immunological response

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4
Q

What is primary haemostasis?

A

Primary haemostasis is the aggregation of platelets

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5
Q

What is secondary haemostasis?

A

Secondary haemostasis is the conversion of fibrinogen into fibrin

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6
Q

Surface of what is an important component in coagulation?

A

The surface of platelets is an important component in the process

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7
Q

What do anticoagulants prevent?

A

Prevent thrombosis

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8
Q

What does fibrinolysis reverse?

A

Reverses thrombosis

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9
Q

What is fibrinogen converted into and by what?

A

Fibrinogen is converted into a fibrin mesh by thrombin which is a protease

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10
Q

What is thrombin converted from?

A

Prothrombin

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11
Q

What does arterial thrombosis most result from?

A

Mostly result from atheroma rupture or damage to the endothelium (e.g. MI, stroke)

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12
Q

What type of thrombosis is arterial thrombosis?

A

Platelet-rich “white” thrombosis

o Mostly primary

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13
Q

What can arterial thrombosis do?

A

May block downstream arteries

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14
Q

What does venous thrombosis often result from?

A

Often results from stasis or a hyper-coagulant state

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15
Q

What type of thrombosis is venous thrombosis?

A

Platelet-poor “red” thrombus

o Mostly secondary

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16
Q

Where can venous thrombosis move to?

A

May move to lungs

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17
Q

What is usually being inhibited?

A

Usually coagulation is being inhibited

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18
Q

What is coagulation inhibited by?

A

o Prostaglandins
o Antithrombin and Heparan
o Nitric Oxide

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19
Q

What does the tissue plasminogen activator cleave?

A

Cleaves plasmin into D dimer (a fibrin degradation product)

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20
Q

What does vonWillebrand factors activate?

A

activates platelets and makes them clump together

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21
Q

What does tissue factor initiate?

A

Initiates clotting

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22
Q

What is Virchow’s triad?

Study These Flashcards
A

Stasis-Static blood lacks kinetic energy and tends to clot
Endothelial damage-Surgery
Hyper-coagulant state-Infection/sepsis

23
Q

What do valves do in veins?

Study These Flashcards
A

Valves in veins prevent backflow of blood

24
Q

what do nearby muscles of the veins do?

Study These Flashcards
A

Contraction of nearby muscles squashes veins, acting as a pump to return blood to
the heart

25
What does blood do around valves?
Blood tends to eddy around the valves increasing the risk of stasis
26
Why does DVT occur?
If venous return is blocked, the affected organ becomes congested with fluid
27
What happens to pressure in DVT?
There is increased pressure so there is more filtration
28
What risk is there in DVT?
The risk is that the thrombosis might become dislodged and make its way back to the heart
29
What is the fate of thrombus?
- Resolution - Embolism - Organised - Recalled and organised
30
What is there a higher risk of in proximal DVT and what are the symptoms?
Higher risk of pulmonary embolism and post-thrombotic syndrome - Pain, swelling, maybe even ulcers
31
What does distal DVT rarely cause?
- Rarely cause pulmonary embolism | - Rarely causes post-thrombotic syndrome
32
What can a small venous thrombus cause?
A slight VQ(ventilation perfusion) mismatch or small infarct zone
33
what can a large venous thrombus cause?
A saddle embolism blocking both pulmonary arteries
34
What activates platelets?
Von Willebrand factor on subendothelial cells activates platelets
35
What do circulating VWF bind to?
Circulating VWF may bind to exposed subendothelial cells
36
What can also express VWF?
Activated endothelial cells can also express VWF
37
What do activated platelets release and what do these bind to?
The activated platelets release Thromboxane A 2 (TxA 2 ) & Adenosine diphosphate (ADP) which induce receptors for fibrinogen - These bind to receptors on adjacent platelets and increase the expression of the glycoprotein complex GPIIb/IIIa
38
What else can platelets be activated by?
Platelets can also be activated by thrombin, collagen and many other mediators
39
What does fibrinogen act as?
Fibrinogen acts as a tether holding the platelets together (this is not blood coagulation)
40
What is fibrinogen?
Fibrinogen is the soluble precursor to fibrin and is in the circulation
41
What do a clump of platelets form?
Once you have a clump of platelets, they form a negatively charged surface which is required for coagulation
42
Coagulation pathway process
See notes
43
What is the GLA domain?
GLA domain is 10-12 glutamic acids in the N-terminus of the | molecule converted to gamma-carboxyglutamic acid (Gla)
44
What is the formation of gamma-carboxyglutamic acid dependent on?
Vitamin K dependent process
45
What inhibits the production of carboxygutamic residues?
warfarin inhibits production of carboxygutamic | residues
46
Extrinsic pathway
See notes
47
What is the intrinsic pathway activated by?
Activated when you put blood onto a charged surface such as glass
48
Defects in extrinsic vs inttinsic pathway
Defects in the factors of the extrinsic pathway have far larger physiological effects than mutations in the enzymes of the intrinsic pathway
49
What can inhibit clotting?
Antithrombin inhibits clotting in the first place
50
What is the clot broken down by?
The clot is broken down by plasmin which is activated from plasminogen by tPA
51
What are some thrombolytic agents used for?
Some of these thrombolytic agents such as tissue plasminogen activator and related compounds are used to treat strokes and myocardial infarctions
52
How its anti-thrombin activated?
Heparin binds to the enzyme inhibitor antithrombin III (AT), causing a conformational change that results in its activation
53
What does activated AT do?
activated AT then inactivates thrombin, factor Xa and other proteases
54
What is AT expressed by and what does it do?
AT is expressed by the endothelial cells and inhibits a lot of the enzymes in the coagulation cascade but thrombin and FVII in particular

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