Thrombotic Disorders

Question 1

What is the clinical pathology and investigation of venous thromboembolism?

Answer 1

Venous thrombosis results in back pressure, “red thrombus” eg fibrin and red cells.
Investigations: d-dimer, Doppler USS, VQ scan, CT pulmonary angiogram
Tm: anticoagulants, thrombolysis

Question 2

What is the clinical pathology and investigation of arterial thromboembolism?

Answer 2

Arterial thromboembolism results in ischaemia and infarction, “white clot” eg platelets and fibrin, prinicipally secondary to atherosclerosis
Investigation: Doppler Uss
Acute Tm: thrombolysis, antiplatelet, anticoagulant drugs

Question 3

What are some risk factors for arterial thromboembolism?

Answer 3

Age
Smoking
Sedentary
Hypertension
Diabetes
Obesity
Hypercholesteraemia

Question 4

What are some risk factors for venous thrombosis?

Answer 4

Stasis + Hypercoagulability

Age
Pregnancy
Hormonal therapy
Tissue trauma
Immbility
Surgery
Obesity
Systemic disease
Family history

Question 5

What are the causes, manifestations and treatment of disseminated intravascular coagulation?

Answer 5

DIC is micro vascular thrombus, caused by septicaemia, malignancy, eclampsia. Manifests as microvascular thrombus, resulting in diffuse ischaemia eg gangrene, organ failure. Tm: treat underlying cause, in emergency transfuse platelets and clotting factors