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Flashcards in Thrombosis Parsa Deck (22):
1

What are the components that contribute to thrombosis?

Subendothelial Collagen
Platelets
Coagulation System

2

What causes subendothelial collagen to be exposed?

Endothelial Injury (intact cells protect against thrombosis/ coagulation etc)

3

Endothelial injury due to hypercholesterolemia or inflammation results in

1. Subendothelial collagen exposure
2. Adhesion and Aggregation of platelets to form platelet plug

4

What are the clinical and labratory assessment for assessment for endthelial injury?

1. Inflammation- C proteins
2. Infection- sepsis
3. Massive tissue destruction- obstetrical complications, CA, trauma, burns

5

What is the von Willebrand factor?

located on collagen for receptors of platelets for adhesion

6

Name of the platelet receptor?

GpIb

7

How is aggregation accomplished?

Through the fibrinogen GpIIb-IIIa receptors on different platelets

8

Clinical assessment of platelets

spontaneous mucosal bleeding
petechaie and eccymoses

9

Laboratory assessment of platelets

platelet count
platelet function studies

10

Types of hypercoagulation

Primary- genetic
Secondary- acquired

11

Initial test for coagulation?

Pt and Ptt

12

Other main test for hypercoagulation if PT/PTT are abnormal

Factor 5

13

Secondary Causes of hypercoagulaion?

Prolonged bedrest/immobilization
MI
Atrial fibrillation
Tissue injury (e.g. trauma, surgery, burn)
Cancer
DIC
Heparin-induced thrombocytopenia
Antiphospholipid antibody syndrome
Others: SCA,smoking, contraceptives, etc.

14

Primary causes of hypercoagulation

Point mutation in Factor V (Factor V Leiden)
In ~60% of patients with repeated DVTs
G20210A mutation → ↑prothrombin levels
Other less common and rare conditions:
↑VIII, IX, IX, or fibrinogen (unknown genetics)
↓antithrombin III, C, S, or fibrinolysis
Homozygous homocysteinuria (enzyme def)
Due to linkage with fibrinogen
Anti-phospholipid antibody syndrome (autoimmune)

15

How does aspirin reduce thrombosis?

by blocking TxA2 synthesis (lives the life of platelets/ 7 days)

16

How does warfarin stop thrombosis

antagonizes vitamin K
Too much warfarin= too much bleeding (give pt. vitamn K or clotting factors)

17

What is heparin's role in preventing thrombosis?

It works with antithrombonin III and prevents thrombosis 1000 times

18

Downside of heparin?

It can cause antbodies to come and signal IgG to produce an auto immune response leading to aggragation of platelets and cause coagulation of endothelium which can lead to thrombosis

19

What is a complication of heparin therapy?

hemmoragic necrosis

20

Which substances promtote formation of plasmin that breaks down the fibrin and dissolves the blood clot or thrombus.

streptokinase and urokinase

21

Fragmented blood cells trying to get by called?

schistocytes (helmet cells)

22

What leads to DIC?

consumes clotting factors by producing microthrombi
(injury, tissue destruction, sepsis)
microthrombi get stuck in capillaries

Plasminogen also acting
Plugging and bleeding at same time
Pt. has low plateles but no being submitted because of plasminogen (d dimer test elevated)