Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y1 CARDIOLOGY > Atherosclerosis, Thrombosis, Embolism > Flashcards

Atherosclerosis, Thrombosis, Embolism Flashcards

1
Q

Define ‘thrombosis’

A

Formation of a mass (thrombus) from the constituents of blood within the vasculature during life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does a thrombus differ from a clot?

A

Thrombus must form during life in the body; clots can form when blood is extracted post-mortem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 3 components of Virchow’s triad?

A

Changes in blood flow
(stasis of blood flow causes MARGINATION of platelets)
Changes in blood coagulability
(protein C and S, antithrombin mutations)
Endothelial damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Give some examples of hypercoaguable aquired states

A 
Myocardial infarction
Immobility
Cancer
Prosthesis
AF
Cardiomyopathy
Oral contraceptive use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Arterial thrombi are red. True/False?

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where do arterial thrombi often lodge?

A

Coronary, cerebral, femoral circulations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Define ‘embolism’

A

Detached intravascular solid/liquid/gas mass carried distal to point of origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Venous emboli commonly infarct peripheral circulation. True/False?

A 
False
Very rare (carried to pul circulation, more likely lodge there)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give examples of factors causing endothelial injury

A 
Smoking
Hyperlipidaemia
Hypertension
Toxins
Infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Give examples of what happens due to endothelial dysfunction

A

Increased permeability

Macrophage + platelet adhesion and activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Once macrophages are activated on the endothelial surface, what do they generate?

A

Oxidative free radicals

Cytokines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do oxygen free radicals do to LDL?

A

Ingest and trap it within macrophages, forming foam cells/fatty streaks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

D-dimer can both rule out and diagnose DVT. True/False?

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is D-dimer?

A

A breakdown product of fibrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If D-dimer levels are low, a DVT is unlikely. True/False?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If D-dimer levels are high, a DVT is very likely. True/False?

A

False

D-dimer levels are raised by many things (infection, MI, surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

If your D-dimers are elevated, what is the next investigation for diagnosing a DVT?

A

(Doppler) ultrasound

CT scan if ilieo-femoral veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If your D-dimers are low and US negative, DVT can be excluded. True/False?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If your D-dimers are high but US negative, DVT can be excluded. True/False?

A

False

Repeat US before completely excluding DVT

20
Q

What is the mainstay of DVT treatment?

A

Anticoagulation (LMWH heparin, warfarin/NOACS)
TED compression stockings
Analgesia
Calf muscle exercises

21
Q

What are the investigations of choice for PE?

A

D dimer
V/Q scan
CTPA (gold standard)

22
Q

What is the advantage of a caval filter for acute PE?

A

Prevents recurrence of PE in short term

23
Q

What is the drawback of a caval filter?

A

Increases risk of DVT - patients will require anticoagulation if long-term filter

24
Q

When is warfarin contraindicated?

A

Pregnancy

Increased haemorrhage risk (uncontrolled drug abuse, dementia etc.)

25
Q

What are the risk factors for atheroma?

A

Smoking, hypertension, hyperlipidaemia, DM, age, sex (males), genetics

26
Q

What is the pathogenesis of atheroma?

A

Primary endothelial injury
Accumulation of lipids and macrophages
Formation of foam cells and fatty streak
Increased size of collagen cap
Fibrofatty plaque
Arterial wall weakness and loss of lumen patency
(Can form a collagen cap and platelet plug = THROMBUS)

27
Q

What are the complications of atheroma?

A

Stenosis (narrowing of lumen)
Thrombosis
Aneurysm (abnormal dilatation due to weakness in wall)
Dissection (splitting within media by flowing blood)
Embolus

28
Q

What are the common causes of aneurysm?

A 
Myocytic
AV
Dissecting
Congenital
Atherosclerotic
Traumatic
Syphilitic
29
Q

What are the common causes of dissection?

A 
Atheroma
Hypertension
Trauma
Coarctation
Marfans
Pregnancy
30
Q

What do statins inhibit?

A

HMG-CoA reductase (reduce LDL formation)

31
Q

What is metabolic syndrome?

A

Type 2 DM
Obesity
Hyperlipidaemia
(Predisposes you to atherosclerosis)

32
Q

What score is used to calculate risk of atherosclerosis?

A

Assign score

33
Q

What is the difference between DVT and PE?

A

DVT: Thrombi in venous valve pockets and sites of stasis
PE: Thromboembolus detach and travel to RHS of heart, blocking vessels in the lung

34
Q

What score is used to predict the probability of DVT/PE?

A

Wells score
(0: D dimer)
(1-3: imaging)

35
Q

What are the challenges of new forms of anticoagulation?

A

NOACS (e.g. rivaroxaban, epixaban, dabigatron) are irreversible, wherease VKA is

36
Q

What is the treatment of choice in VTE for active cancer patients?

A

Fragmin

37
Q

Compression stockings are the only treatment for…

A

Post thrombotic syndrome (a venous stasis syndrome occurring after DVT)

38
Q

When are IVC filters indicated?

A

When anticoagulation is contraindicated

39
Q

The two main complications of deep vein thrombosis (DVT) are…

A

PE

Post thrombotic syndrome

40
Q

What are the main risk factors for VTE?

A 
HRT
Thrombophilia
Pregnancy
Trauma
Surgery
Malignancy
Immobility
Pulmonary hypertension
Vasculitis
Obesity
Previous VTE
41
Q

What are the two main types of DVT?

A

Proximal (ileo-femoral)

Distal (popliteal)

42
Q

In what situation of DVT would thrombolysis be considered?

A

If it is ilieo-femoral veins affected

43
Q

What are some common signs of DVT?

A

Calf warmth, tenderness, swelling, erythema, mild fever, pitting oedema

44
Q

What are some differentials for DVT?

A

Bakers cyst
Superficial thrombophlebitis
Calf cellulitis

45
Q

What are some symptoms associated with PE?

A 
SOB (typically acute)
Pleuritic chest pain
Haemoptysis
Leg pain/ swelling
Collapse/dizziness
(Pyrexia, tachycardia, hypotension)

Y1 CARDIOLOGY (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions