Flashcards in Thrombosis and Risk Factors Deck (24):
1
Risk factors for thrombosis
Virchow's triad- flow, composition or vessel wall
2
Outline the brief pathology of arterial thrombosis
Atherosclerosis, rupture of atheromatous plaque, endothelial injury, platelet aggregation
3
Describe the composition of thrombi in venous thrombosis
Pred. fibrin and RBCs, less platelets
4
Complication of venous thrombosis
Venous thromboembolism (VTE)
5
Treatment for VTE
Low molecular weight heparin e.g. fondaparinux
Newer anticoagulants e.g:
Xa inhibitors rivaroxaban
IIa inhibitors dabigatran
Compression stockings
6
Natural procoagulants
Clotting factors
7
Natural anticoagulants
Antithrombin III
Proteins C+S
Fibrinolytics
8
How does heparin work?
Increases antithrombin activity
9
Does LMWH predominantly target Xa or IIa?
Xa
10
Does fondaparinoux predominantly target Xa or IIa?
entirely Xa
11
Diagnostic test for VTE
Wells score
D-dimer test
Ultrasound
VQ scan
12
What test is used to measure the breakdown products of fibrin clots- specific to plasmin acting on fibrin
D-dimer
13
What does the VQ scan pick up in PE?
Ventilation:perfusion mismatch
14
What are the advantages of novel anticoagulants?
Dose is uniform for post patients and rapid onset
15
Target INR
2.5
16
Familial or acquired disorder of the haemostatic mechanism likely to predispose to thrombosis
Thrombophilias
17
Heritable thrombophilias
Antithrombin def
Protein C def
Protein S def
FV leiden-activated protein C resistance
Prothrombin 20210A
Dysfibrinogenaemia
18
Prothrombin 20210A
Too much prothrombin
19
An example of an acquired thrombophilia
Antiphospholipid syndrome- autoimmune, hypercoagulable state
20
Clinical features of thrombophilia
VTE
Superfical thrombophlebitis
Thrombosis of cerebral, axillary, portal and mesenteric veins
Coumarin induced skin necrosis (PC deficiency)
Obstetic complications- fetal wastage- thrombosis of placental circulation
21
What is the function of protein C
Breaksdown Va and VIIIa
22
What is the function of protein S
Cofactor for protein C
23
Describe factor V leiden
Va resistant to protein C
24