4.4 Thrombosis Flashcards
What is thrombosis?
Pathologic blood clotting in the blood vessels
What are the indications of a pre-mortem clot?
- Lines of Zahn
- Attachment to the vessel wall
What are the major risk factors for thrombosis?
- Hypercoagulable state
- Disruption in blood flow
- Endothelial wall damage
How does the endothelium prevent thrombosis?
- Barrier over collagen
- PGI2 blocks platelet aggregation
- Production of NO -> Vasodilation
- Heparin-like molecules activate ATIII
- Thrombomodulin release to modify thrombin
How does Vitamin B12 deficiency cause increased risk for thrombosis?
It leads to elevated homocysteine levels which damages the endothelium and leads to increased risk of thrombosis
What is cystathione beta synthase deficiency?
Results in high levels of homocysteine that lead to increased risk of thrombosis
What is a major risk factor with Protein C/S deficiency?
Increased risk for warfarin induced skin necrosis
What is Factor V Leiden?
Mutated Factor V that cannot be cleaved which leads to hyper coagulable state - most common cause
Prothrombin 20210A
Excess production of prothrombin
ATIII Deficiency
Decreases the protective effect of heparin like molecule released by the endothelium
What is a result that indicates ATIII deficiency?
PTT does not increase with heparin dosing
What is the relationship of oral contraceptives and coagulation?
They induce a hyper coagulable state as estrogen increases the production of coagulation factors.
