Brainscape's Knowledge GenomeTM

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


See full index

Cardiovascular System > Deep Vein Thrombosis & Pulmonary Thromboemolism > Flashcards

Deep Vein Thrombosis & Pulmonary Thromboemolism Flashcards

1
Q

What is a thrombus (2)

A
  • Clot arising in the wrong place (arterial or venous)

* A solid structure arising inappropriately in a fluid system

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

What is Haemostasis

A

Physiological process of maintaining vascular integrity

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

What does a clot consist of (4)

A

Fibrin
Platelets
Red blood cells
White blood cells

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

What is one of the functions of the endothelium

A

• Endothelium protects components of blood being activated

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

What happens when the endothelium is activated (4)

A

endothelium exposes collagen, smooth muscle and connective tissue
• When the damage occurs tissue factors VIII and VII that normally circulate the blood inactivated interact with factor X
• Factor X interacts with Factor V to initiate the conversion of prothrombin to thrombin
• This reaction then causes fibrinogen to be converted to fibrin

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

What happens to fibrin during coagulation (2)

A

Becomes insoluble

Forms cross links

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

What components are soluble and what are insoluble

A

Everything before the production of fibrin is soluble

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

What does Factor XIII hep do

A

Helps cross link polymerised fibrin to make it a strong structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Define White thrombus

A

white arterial thrombus. This consists of platelets and fibrin, and there is a lack of red blood cells due to the fast flow of the blood preventing the incorporation of red blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define Red thrombus

A

red venous thrombus. This consists of red blood cells and fibrin and there are more red blood cells due to the slow flow of blood which allows more red blood cells to be incorporated

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

Mechanism of arterial thrombus

A

usually rupture of atherosclerotic plaque

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

Mechanism of venous thrombous

A

Combination of Virchows triad especially stasis and hypercoagubility

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

Location of origin of arterial thrombus (2)

A

Arteries

left heart chambers

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

Location of origin of venous thrombosis

A

Venous valves and venous sinusoids of muscles

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

Arterial thrombus results in (2)

A

Ischaemia or Infarction

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

Venous thrombus results in

A

back pressure

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

Diseases associated with arterial thrombus

A

DVT

PE

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

Composition go arterial thrombus

A

Platelets

Fibrin

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

Composition of venous thrombus

A

Red blood cells

Fibrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Virchows Triad

A

3 broad factors that contribute to thrombosis
Stasis
Hypercoagulability
Endothelial damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What can causes stasis (2)

A

Immobility

Long haul travel

22
Q

What can cause acquired hypercoagulability (3)

A

Pregnancy
Cancer
Sepsis

23
Q

What can cause endothelial dysfunction (3)

A

Hypertension
Smoking
High cholesterol

24
Q

What can cause endothelial damage (3)

A

Indwelling venous catheters
Trauma
Surgery

25
Q

How does Pregnancy
Cancer
Sepsis increase hypercoagulability

A

Increases the production of tissue factor

26
Q

Embolism

A

Intravascular material that migrates from its original location to a distal vessel

27
Q

Thromboemolism

A

Movement of blood clot along a vessel

28
Q

Examples of VTE (4)

A
  • Limb deep vein thrombosis (DVT)
  • Pulmonary embolism (PE)
  • Visceral venous thrombosis
  • Intracranial venous thrombosis
29
Q

Risk Factors of VTE (3)

A

Surgery
Abdominal/Pelvic malignancies
Oral contraceptive

30
Q

Signs and Symptoms of DVT (7)

A
  • Unilateral limb swelling
  • Persisting discomfort
  • Calf tenderness
  • Warmth
  • Redness- erythema
  • Prominent collateral veins
  • Unilateral pitting oedema
31
Q

Diagnosis of suspected DVT (3)

A
  1. Clinical assessment and carry out Wells score (pre-test probability sore)
  2. Blood test: D-dimer if low Wells score
  3. Imagine: compression ultrasound if positive D-dimer or high pre-test probability score
32
Q

DVT Wells Score >/=3 (2)

A

High probability

Imaging- compression US

33
Q

DVT Wells Score 1 or 2

A

Intermediate probability

Imaging- compression US

34
Q

DVT Wells Score =0

A

Low probability

D-dimer blood test

35
Q

A negative D-dimer result

A

means that DVT or PE can be ruled out.

36
Q

A positive D-dimer result means that

A

the patient has to undergo further imaging in order to diagnose whether or not he or she has DVT or PE.

37
Q

What is a D-dimer

A

Breakdown product of cross-linked fibrin

38
Q

Symptoms and Signs of PE (5)

A
  • Pleuritic chest pain
  • SOB- dyspnoea
  • Haemoptysis
  • Tachycardia
  • Pleural rub on auscultation- usually due to pulmonary infarction
39
Q

Symptoms and signs of massive pulmonary embolism (7)

A
  • Severe dyspnoea of sudden onset
  • Collapse
  • Blue lips and tongue- cyanosis
  • Tachycardia
  • Low blood pressure
  • Raised venous jugular pressure
  • Sudden death
40
Q

Diagnosis of PE (4)

A

Wells Score or Geneva Score
D-dimer blood test
Isotope ventilation/perfusion scan
CT pulmonary angiogram

41
Q

PE Wells score >/= 6.5 (3)

A

High probability
Imagine- isotope ventilation/perfusion scan
CT pulmonary angiogram

42
Q

PE Wells score 4.5-6.0 (3)

A

Moderate probability
Isotope ventilation/perfusion scan
CT pulmonary angiogram

43
Q

PE Wells score = 4.0 (2)

A

Low probability

D-dimer blood test

44
Q

Potential long-term consequence of pulmonary embolism (2)

A
  • Most recover fully

* Pulmonary arterial hypertension

45
Q

In a patient with diagnosed VTE it is important to consider (3)

A
  • Was there a clear cause or precipitant- hospital, surgery
  • Any symptoms or signs to suggest underlying malignancy
  • Consider risk of recurrence
46
Q

Aims of Treatment of VTE (3)

A
  • Prevent clot extension
  • Prevent clot embolism
  • Prevent recurrent clot
47
Q

Treatment options (anticoagulant) IV

A

Unfractionated heparin

48
Q

Treatment options (anticoagulant) subcutaneous

A

low molecular weight heparin

49
Q

Treatment options enteral

A

Warfarin and direct oral anticoagulants

50
Q

What treatment option must be reserved for thrombolysis

A

massive PE (Alteplase)

51
Q

Prevention of VTE

A
  • Early mobilisation
  • Anti-embolism stockings
  • Other mechanical methods of thromboprophylaxis
  • Pharmacological thromboprophylaxis
52
Q

How do you develop a pulmonary infarction after a PE (3)

A
  • Blockage to a branch of the pulmonary artery = increase in pressure within pulmonary vasculature
  • Force within bronchial artery may be insufficient to overcome this
  • ‘Leakage’ of blood into alveolar space occurs, and leads to infarction

Cardiovascular System (42 decks)

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