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Flashcards in Thrombosis And Embolism Deck (20)
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1

What is a Thrombosis

Formation of a solid mass of blood within the circulatory system

2

What is Virchow’s Triad

An explanation of how a thrombus forms, due to changes in 2 of;

Vessel wall
Blood flow
Blood components

3

What are 4 causes of vessel/ endothelial wall damage

Atheroma
Direct injury/ trauma
Inflammation
Myocardial Infarction

4

What are 2 possible problems with blood flow
Where are they more common and why

Stasis and Turbulent flow
In veins, due to reduced flow and valves

5

What are the problems with blood components

Identify 7 groups of people who may have this, and how?

Blood can enter a hypercoagulable state, becoming ‘sticky’

Pregnancy/ postpartum
Post surgery
Trauma/ fractures
Burns
Oral contraceptive users
Cancer patients- Above 5 have increased fibrinogen and factor 8

Smokers- Activation of factor 12

6

Compare the appearances of arterial and venous thrombi

Arterial;
- Pale
- Granular
- Lines of Zahn (layers of Platelets, Fibrin, RBC, Platelet etc.)
- Low cell content

Venous;
- Soft
- Gelatinous
- Deep red
- Higher cell content

7

What are the outcomes/ complications of Thrombosis

- Lysis/ resolution
- Propagation
- Organisation
- Recanalise
- Embolise

8

What is propagation of a thrombosis
How do thrombi propagate in arteries and veins

Growth/ spread of a thrombosis

Proximally in veins
Distally in arteries

9

What is Organisation of a thrombosis
How does the vessel lumen end up

When the thrombus undergoes fibrous repair and forms a fibrous scar on the vessel wall

Remained obstructed

10

What is Recanalisation of a thrombosis

New channels formed through an organising thrombus, so that blood flow is partially re-established

11

What are the Venous and Arterial effects of a Thrombosis on the tissue

Venous;
- Oedema
- Ischaemia
- Infarction
- Congestion


Arterial;
- Infarction
- Ischaemia

12

What is an Embolism

What is the most common type of Emboli

The blockage of a blood vessel by Solid/ Liquid or Gas at a site distant from its origin

Thrombo-emboli

13

Compare the paths and end-results of thromboemboli in Arteries and Veins

In veins, flow from from smaller to larger vessels so will go through heart and embolise in pulmonary arteries

In arteries, flow from larger to smaller arteries, so can end up anywhere in systemic circulation, but mainly in lower limbs

14

Identify 7 Predisposing factors for a Deep Vein Thrombosis

- Immobility
- Post surgery
- Pregnancy/ Post-Partum
- Oral contraceptives
- Severe burns
- Cardiac failure
- Disseminated cancer

15

What are 3 outcomes of a Pulmonary Thromboembolism

1. Large embolus in main Pulmonary Artery= Sudden death

2. Small embolus in Peripheral Pulmonary Artery= Pulmonary Infarct

3. Multiple small emboli= Pulmonary hypertension

16

Compare Major and Minor Pulmonary Emboli
How do they present

Major: Medium vessels blocked
- Short of breath +/- cough and bloody sputum


Minor: Small peripheral arteries blocked
- No symptoms or minor shortness of breath

17

Name 6 other types of embolism

- Air
- Amniotic fluid
- Nitrogen
- Medical equipment
- Tumour cells
- Fat, Bone marrow

18

What are 2 methods of preventing a DVT/ PE
Suggest 2 examples of each

Prevent stasis;
- Early mobilisation after illness/ surgery
- Leg compressions during/ after surgery


Prevent hypercoagulation;
- Aspirin
- Heparin/ Warfarin

19

Identify 5 treatments for a thrombus

- Clot busters
- IV or Subcutaneous Heparin/ Oral Warfarin
- Filters in IVC
- Embolectomy
- Noval Oral anticoagulants (NOAC)

20

4 Noval Oral Anticoagulants are;
- Dabigatran
- Rivaroxaban
- Apixaban
- Edoxaban

How do 3 of these work?

Anti factor Xa (Not Dabigatran)