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year 2 EMS MOD > Atheroma, Thrombosis & Embolism > Flashcards

Atheroma, Thrombosis & Embolism Flashcards

1
Q

what is the definition of atheroma?

A

Intimal lesion that protrudes into a vessel wall. It consists of a raised lesion with a soft core of of lipid (mainly cholesterol and cholesterol esters) and is covered by a fibrous cap.

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2
Q

what is the two features of an atheroma?

A

fibrous cap

necrotic centre

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3
Q

what are commonly affected vessels for atheroma?

A 
bifurcations 
abdominal aorta 
coronary arteries 
popliteal arteries 
carotid vessels
circle of willis
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4
Q

what are non-modifiable major risk factors for development of atherosclerosis?

A

increasing age
male gender
family history
genetic abnormalities

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5
Q

what are modifiable major risk factors for development of atherosclerosis?

A 
hyperlipidemia Ldl:Hdl 
hypertension 
cigarette smoking 
diabetes 
c-reactive proteins
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6
Q

How does atherosclerosis develop?

A

it develops as chronic inflammatory response of the arterial wall to endothelial injury.

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7
Q

how does lesion progression occurs?

A

occurs through interactions of modified lipoproteins, monocyte-derived macrophages, T-lymphocytes and the normal cellular constituent of the arterial wall

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8
Q

what is the contemporary view of atherosclerosis?

A

the response-to-injury hypothesis

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9
Q

what is the fatty streak?

A

its the earliest lesion in atherosclerosis and is composed of lipid filled foamy macrophages

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10
Q

how does the fatty streak begin?

A

begins as multiple minute flat yellow spots that eventually coalesce into streaks

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11
Q

what does atherosclerotic plaque consist of?

A

consists of intimal thickening and lipid accumulation

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12
Q

what does atherosclerotic appear as?

A

appears white yellow and superimposed thrombus on the plaque appears red.

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13
Q

what is a thrombus?

A

a solid mass of blood constituents formed within the vascular system in vivo

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14
Q

where is arterial thrombosis most commonly superimposed on?

A

on a atheroma

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15
Q

what is venous thrombosis most commonly due to

A

stasis

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16
Q

what are three areas of virchows triad

A

endothelial injury
hyper coagulability
abnormal blood flow

17
Q

what is the typical mechanism arterial thrombosis?

A

Typically from rupture of atheromatous plaque

18
Q

what is the typical mechanism venous thrombosis?

A

Typically from combination of factors from Virchow triad

19
Q

where is arterial thrombosis normally located

A

Left heart chambers, arteries

20
Q

where is VTE normally located?

A

Venous sinusoids of muscle and valves of veins

21
Q

what diseases associated with arterial thrombosis?

A

Acute coronary syndrome
Ischaemic stroke
claudication

22
Q

what diseases associated with VTE?

A

Deep vein thrombosis (DVT)

Pulmonary embolism

23
Q

what’s the composition of arterial thrombosis?

A

Mainly platelets

24
Q

what’s the composition of VTE?

A

Mainly fibrin

25
Q

how do you treat arterial thrombosis?

A

Anti-platelet agents (clopidogrel)

26
Q

how do you treat VTE?

A

Anticoagulants (heparin, warfarin)

27
Q

what are the causes of endothelial damage? 5

A 
smoking 
hypertension
surgery 
catheter PICC lines
trauma
28
Q

what’s the hereditary components of hypercoagulability? 3

A

Factor V leiden

Prothrombin G20210A

Protein C and S deficiency

29
Q

what’s the acquired factors of hypercoagulability? 5

A 
Cancer 
chemotherapy 
OCR/HRT 
Pregnancy 
Obesity 
HIT
30
Q

what are the two causes of stasis?

A

immobility

polycythemia

31
Q

what are the differences between clot vs thrombus?

A

platelets only involved in thrombus

clot can occur inside or outside clot whereas thrombus occurs only inside vessel

clot is gelatinous whereas thrombus is firm

thrombus attached to the vessel wall whereas clot isn’t attached

32
Q

what leads to an embolisation?

A 
occlusion of vessel 
dissolution 
incorporation into vessel wall 
recanalisation 
embolisation
33
Q

what is an embolus?

A

A mass of material in the vascular system able to become lodged in the vessel and block its lumen

34
Q

what is the most common embolism and where is it derived from?

A

Pulmonary embolus derived from deep vein thrombosis

35
Q

what are the types of emboli? 7

A 
thrombus derived 
atheromatous plaque material 
vegetation on heart valves 
fragments of tumour 
amniotic fluid 
gas 
fat

year 2 EMS MOD (17 decks)

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