Thrombotic Disorders Flashcards
(22 cards)
What are the elements of haemostasis?
Primary haemostasis
Blood coagulation
Fibrinolysis
What is involved in primary haemostasis?
Vasoconstriction
Platelet adhesion
Platelet aggregation
What is incolved in coagulation?
Insoluble fibrin formation
Fibrin cross-linking
What is the process behind fibrinolysis?
Factor XII, tPA and urokinase convert plasminogen into plasmin
Fibrin is converted into fibrinogen and fibrin degredation products by plasmin
What is Virchow’s triad of thrombosis?
Stasis
Hypercoagulability
Vessel damage
What causes blood stasis?
Bed rest
Travel
What causes hypercoagulability?
Pregnancy
Trauma
What causes vessel damage?
Atherosclerosis
What are the types of thrombosis?
Arterial
Venous
Microvascular
What type of clot is found in an arterial thrombus?
“White clot” composed of platelets and fibrin
What is arterial thrombus typically second to?
Atherosclerosis
Risk factors for arterial thrombosis
Age Smoking Sedentary lifestyle Hypertension Diabetes mellitus Obesity Hypercholesterolaemia
Management of arterial thrombosis
Primary prevention -Lifestyle modification -Treatment of vascular risk factors Acute presentation -Thrombolysis -Antiplatelet/anticoagulant drugs Secondary prevention
What type of clot is found in a venous thrombus?
“Red thrombus” composed of fibrin and red cells
What is the main cause of venous thrombus?
Stasis and hypercoagulability
Risk factors of venous thrombosis
Increasing age Surgery Pregnancy Obesity Hormonal therapy (COCP/HRT) Systemic disease Tissue trauma Family history Immobility
Diagnosis of venous thrombosis
Pretest probability scoring -Wells score -Geneva score Laboratory testing if pretest probability low -D-dimer Imaging
Venous thrombosis treatment
Anticoagulants
- LMWH
- Coumarins (warfarin)
- DOACs
Thrombolysis only in selected cases
What is heritible thrombophilia?
An inherited predisposition to venous thrombosis
Common causes of heritable thrombophilia
Factor V Leiden
Prothrombin 20210 - produce too much prothrombin
DIC
Disseminated Intravascular Coagulation
Microvascular thrombus
Composed of platelets and/or fibrin
Results in diffuse ischaemia
