Venus Thrombosis & Pulmonary Thrombo-Embolism Flashcards Preview

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Flashcards in Venus Thrombosis & Pulmonary Thrombo-Embolism Deck (23)
1

Where do venous thrombi mostly arise?

In the deep veins of the legs

2

What are the risk factors for venous thrombosis?

Slowing of blood and hyper coagulability - (endothelial dysfunction is not as relevant)

3

What causes slowing of blood?

Imobility, thickened blood, right heart failure, dehydration

4

What causes endothelial dysfunction?

direct trauma, surgical trauma, injury from catheters

5

What causes hypercoagulability?

post operative, post MI, malignancy, chemotherapy, oestrogen, anti-phosphilipid antibody syndrome, nephrotic syndrome, obesity, cigarette smoking, inflammatory disease, genetic abnormalities

6

What genetic abnormalities lead to hyper coagulability?

mutation in factor V leading to inability of APC to bind, prothrombin mutation leading to increased amount of prothrombin in circulation

7

What is thrombophilia?

A group of inherited or acquired disorders that increase a person’s risk of developing arterial or venous thrombosis

8

What are the symptoms of DVT?

leg is warm. swollen, pain, discomfort - but symptoms are often not present at all

9

Where are DVT most common?

In the calf

10

Where are DVT most clinically significant?

Proximal veins - pelvic and deep femoral veins most likely to cause a pulmonary embolism

11

What are the symptoms of a large pulmonary thrombo-embolism?

sudden collapse and death or acute cor pulmonale with SOB, hypotension, cyanosis

12

What are the symptoms of a medium thrombo-embolism?

SOB, cough, acute cor pulmonale

13

What are the symptoms of a small pulmonary thrombo-embolism?

may be clinically silent or may lead to chronic pulmonary hypertension or chronic cor pulmonale

14

What are the complications of a medium or small pulmonary thrombo-embolism?

Pulmonary infarct - usually only occurs if there are underlying cardiovascular problems or underlying hypoxemia

15

What are the features of a pulmonary infarct?

Wedge shaped coagulative necrosis that is haemorrhagic with a fibrinous exudate

16

What are the symptoms of a pulmonary infarct?

haemoptysis, pleuritic chest pain and pleural friction rub

17

What is the fate of pulmonary emboli?

dissolution and or organisation and or recanalisation

18

What is a saddle embolus?

An embolus across the pulmonary trunk and right and left pulmonary arteries

19

What is the treatment for pulmonary embolism?

Anticoagulant drugs

20

What is the aim of treatment of pulmonary embolism?

To prevent expansion of thrombus in the leg and limit the possibility of a subsequent embolism

21

What are the long term outcomes of DVT?

fibrinolysis, organisation, recanalisation of the thrombus, varicose veins, chronic venous insufficiency, oedema, venous stasis, tissue pigmentation, dermatitis, chronic ulceration

22

How is DVT prevented?

Anticoagulant drugs, mobilisation, exercise, compression stockings

23

What are some other common sites of venous thrombosis?

veins of upper limb, cerebral venous sinuses, mesenteric veins, portal vein, hepatic vein