48 - Vascular Pathology II Flashcards
Example of a factor on platelets, and its ligand on vascular endothelium
GP1b on platelets sticks to exposed Von Willebrand factor
What do platelets do when activated?
Change shape, release granules (factors, fibrinogen)
Thrombomodulin
Changes thrombin from activator of clotting to an inhibitor
Effector of fibrinolysis
Tissue plasminogen activator (tPA)
Mechanism of tissue plasminogen activator action
Tissue plasminogen activator binds to fibrin, activates plasmin. Plasmin degrades fibrin.
Thrombus
A blood clot within an intact, living cardiovascular system.
Contents of a thrombus
RBC, WBC, platelets
Appearance of a thrombus
Red and white stripes (layers of RBC and platelets+fibrin) - called ‘lines of Zahn’.
Difference in appearance between arterial and venous thrombi
Arterial are white.
Venous are red.
Why do arterial thrombi appear white?
Greater proportion of platelets and fibrin.
Why do venous thrombi appear red?
Higher proportion of RBC
What are arterial thrombi mostly associated with?
Endothelial dysfunction or damage
What are venous thrombi mostly associated with?
Blood stasis, hypercoagulability
Useful drug for preventing arterial thrombi
Aspirin (interferes with platelet thromboxane production)
Useful drug for preventing venous thrombi
Warfarin (interferes with coagulation cascade)
Outcome of laminar flow in blood vessels
Blood cells don’t touch vascular wall
Why do thrombi form?
Virchow’s triad of factors influencing clotting:
1) Endothelium (EG: injury)
2) Blood flow (EG: non-laminar flow)
3) Blood composition (EG: hypercoagulability)