Thrombotic Disorders Flashcards
What kind of clot is found in the arterial vs venous system?
Arterial = White clots (platelets & fibrin)
Venous = Red Clots (Fibrin & Red cells)
What causes venous vs arterial thrombi?
Arterial - Secondary to Atherosclerosis
Venous - Secondary to Stasis & Hypercoagulability
Risk factors for an arterial thrombosis?
- Age
- Smoking
- Sedentary
- HTN
- DM
- Obesity
- Hypercholesterolaemia
How do we manage an arterial thrombus?
Primary prevention with lifestyle modification and treating the risk factors
Acutely: thrombolysis & Anti-platelets or Anti-coags
Secondary prevention
Risk factors for a DVT or PE?
Age
Surgery
Tissue Trauma
Immobility
Obesity
Pregnancy
Hormonal Therapy
FH
Systemis disease
What systemic diseases put you at risk of a DVT?
Cancers
Myeloproliferative Neoplasm
Autoimmune e.g. IBD, SLE or Anti-phospholipid syndrome
How can we test for a DVT/PE?
Pretest probability scoring (Well’s or Geneva scores)
If probability score is low do a D-dimer
Doppler US
V/Q scan & CT Pulm Angiogram
How can we treat a DVT/PE?
Anticoagulants e.g. LMWH, Warfarin & DOACs
Thrombolysis only if massive PE
What are the commonest Heritable Thrombophilias?
Factor V Leiden
Prothrombin G20210A
What’s the major cause of microvascular Thrombus?
Disseminated Intravascular Coagulation (DIC)
What makes up microvascular thrombi?
Platelets &/or fibrin
What triggers DIC?
Septicaemia
Malignancy
Eclampsia
What are the consequences of DIC?
Diffuse Tissue ischaemia –> Gangrene & Organ Failure
Consumes platelets/clotting factors –> Bleeding
