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3rd Year - Haematology > 5. Thrombotic Disorders > Flashcards

5. Thrombotic Disorders Flashcards

1
Q

What are the 3 Main Elements of Haemostasis?

A
  1. Primary Haemostasis
  2. Blood Coagulation
  3. Fibrinolysis
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2
Q

What occurs in Primary Haemostasis?

A
  1. Vasoconstriction
  2. Platelet Adhesion
  3. Platelet Aggregation
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3
Q

What occurs in Blood Coagulation?

A
  1. Insoluble Fibrin Formation

2. Fibrin Cross-Linking

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4
Q

What occurs in Fibrinolysis?

A
  1. Urokinase / Tissue Plasminogen Activator (tPA) / Factor XII act on Plasminogen to form Plasmin
  2. Plasmin acts on Fibrin to form Fibrinogen / Fibrin Degradation PRoducts
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5
Q

What is a Thrombus?

A

Clot arising in the Wrong Place

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6
Q

What is a Thromboembolism?

A

Movement of a Clot along a Vessel

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7
Q

What are the Components of Virchow’s Triad?

A

Thombosis:

  1. Stasis - Bed Rest / Travel
  2. Hypercoagulability - Pregnancy / Trauma
  3. Vessel Damage - Athersclerosis
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8
Q

What are the 3 Types of Thrombosis?

A
  1. Arterial
  2. Venous
  3. Microvascular
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9
Q

What are the Risk Factors for Arterial Thrombosis?

A
  1. Age
  2. Smoking
  3. Sedentary Lifestyle
  4. Hypertension
  5. Diabetes Mellitus
  6. Obesity
  7. Hypercholesterolaemia
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10
Q

What are the Features of an Arterial Thrombus?

A
  1. White Clot - Platelets and Fibrin
  2. Results in Ischaemia / Infarction
  3. Principally Secondary to Atherosclerosis
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11
Q

What are Examples of Arterial Thromboembolisms?

A
  1. Coronary Thrombosis - M.I. / Unstable Angina
  2. Cerebrovascular Thromboembolism - Stroke / TIA
  3. Peripheral Embolism - Limb Ischaemia
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12
Q

What is the Management of an Arterial Thrombus?

A 
1. Primary Prevention - Lifestyle Modification / Treatment of Vascular Risk Factors
Acute Presentation:
2. Thrombolysis
3. Antiplatelet / Anticoagulant Drugs
4. Secondary Prevention
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13
Q

What are the Risk Factors for a Venous Thrombosis?

A

Stasis / Hypercoagulability:

  1. Age
  2. Pregnancy
  3. Hormonal Therapy - COCP / HRT
  4. Tissue Trauma / Surgery
  5. Obesity / Immobility
  6. Systemic Disease - Cancer / Myeloproliferative Neoplasms / Autoimmune Disease (IBD / SLE)
  7. Family History
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14
Q

What are the Features of a Venous Thrombus?

A
  1. Red Thrombus - Fibrin and Red Cells
  2. Results in Back Pressure
  3. Principally due to Stasis and Hypercoagulability
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15
Q

What are Examples of Venous Thromboembolisms?

A
  1. Limb Deep Vein Thrombosis
  2. Pulmonary Embolism
  3. Visceral Venous Thrombosis
  4. Intracranial Venous Thrombosis
  5. Superficial Thrombophlebitis
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16
Q

How is a Diagnosis of Venous Thrombosis made?

A
  1. Pretest Probability Scoring - Wells / Geneva Score
  2. Lab Testing if Pretest Probability Low - D-Dimer
  3. Imaging - Doppler Ultrasound / Ventilation/Perfusion (V/Q) Scan / CT Pulmonary Angiogram
17
Q

What are the Aims of Management of a Venous Thrombosis?

A
  1. Prevent Clot Extension
  2. Prevent Clot Embolisation
  3. Prevent Clot Recurrence in Long Term Treatment
18
Q

What is the Management of a Venous Thrombosis?

A
  1. Anticoagulants - LMWH / Coumarins (Warfarin) / DOAC’s

2. Thrombolysis - Massive P.E.

19
Q

What is Heritable Thrombophilia?

A

An Inherited Predisposition to Venous Thrombosis

20
Q

What are

  1. Common Heritable Thrombophilias?
  2. Rare Heritable Thrombophilias?
A
  1. a) Factor V Leiden
  2. b) Prothrombin G20210A
  3. a) Antithrombin Deficiency
  4. b) Protein C Deficiency
  5. c) Protein S Deficiency
21
Q

What are the Features of a Microvascular Thrombus?

A
  1. Platelets and/or Fibrin
  2. Results in Diffuse Ischaemia
  3. Principally in Disseminated Intravascular Coagulation
22
Q

What is Disseminated Intravascular Coagulation?

A

Diffuse Systemic Coagulation Activation

23
Q

When does Disseminated Intravascular Coagulation occur?

A
  1. Septicaemia
  2. Malignancy
  3. Eclampsia
24
Q

What can result from Tissue Ischaemia?

A
  1. Gangrene
  2. Organ Failure
    Note - Consumption of Platelets and Clotting Flactors can lead to Bleeding

3rd Year - Haematology (10 decks)

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