282b - thrombotic disorders Flashcards
ADAMSTS13 fxn? location?
cleaves vWF to make it less efficient in causing clots
surface of endothelium cell
thrombomodulin fxn
binds thrombin and inhibits it
physiologic anticoagulants - ATIII fxn? drug that acts on it?
ATIII - serine protease inhibitor (II, X, IX, XI, CII, VII-TF); heparin makes it much more active
physiologic anticoagulants - protein C fxn? what activates it? cofactor?
activates Protein C,S –I V, VIII
thrombomodulin - formed with thrombin –> activates Protein C
prtn S - circulating free (1/3) –> cofactor for protein C
fibrinolytic system - what breaks up clots? what increases? decreases?
breaks up fibrin via plasmin –> releases D-dimer
tPA, urokinase increases plasmin
Plasminogen activator inhibitor blocks plasmin
where do thrombi form? what is present in this area to prevent thrombi formation?
vein valve sinus - low vWF and high TM and EPCR to try to stop this
preg and thrombus location?
left iliac artery crosses over and on top of left iliac vein –> occludes vein
what kind of surgeries give DVTs?
orthopedic surgeries of hip and LE
veins in leg?
superficial veins - greater and lesser saphenous veins
deep veins - iliac, superficial femoral, popliteal, tibial (deep femoral vein is very short and uncommon location for DVT)
DVT locations?
popliteal, superficial femoral, iliac are common places
DVT symptoms? PE?
unilateral leg swelling, warmth, pain, discoloration
PE - cough, SOB,pleuritic chest pain
lab test for DVT
d-dimer
legs –> US - press down which should compress vein but not artery unless DVT
lung –> CT pulmonary angiograms via dye in arm
VTE complications
PE
Pulmonary HTN - recurrent PE -> destroys lungs
recurrence - high without treatment
Post-thombus syndrome
doesn’t go away - occludes blood flow –> ulcers, swelling, itching
