Disorders of veins Flashcards
What are 4 veins where venous thrombosis are found?
Retinal vein
Pulmonary embolism
DVT
Cerebral vein
What is postthrombotic syndrome a consequence of?
venous hypertension due to persistent venous obstruction & dysfunction of venous valves
What are 4 acquired risk factors?
Age
History of venous thrombosis
trauma
Obesity
What are 4 genetic risk factors?
AT deficiency
FV Leiden
Protein C deficiency
Protein S deficiency
What is Chronic ThromboEmbolic Pulmonary Hypertension (CTPH) characterized by?
Increased mean pulmonary artery pressures, persistence of thrombi & vascular remodeling in pulmonary circulation
What are 2 unspecific symptoms of PE?
Chest pain when breathing (pleuritic pain)
Shortness of breath (dyspnoe)
What does ventilation/perfusion scintigraphy assess?
Pulmonary embolism
What do D-dimers show?
More thrombosis = more fibrinolysis
What does computed tomography show?
PE
What 3 ways is VTE treated?
Low-molecular-weight Heparin
Vit K antagonists
Anticoagulants
When can catheter-directed thrombolysis be used?
Selected DVT
What do compression stockings do?
Improve leg blood flow
What does heparin facilitate?
Interaction of thrombin & FXa with AT
What are 2 types of heparin?
Unfractionated
Low molecular weight
Which heparin is better and why?
Low molecular weight has it is more powerful and is specific for Xa
Lowere HIT risk
What is the minimal sequence required for AT binding & Xa inhibition?
short pentasaccharaide
When is IIa/Xa not inhibited?
Attched or inside clots
What is the MoA of vit K antagonists?
Block synthesis of II, VII, IX, X, PC, PS
What triad did Virchow use to describe clot propagation?
- blood clotting
- irritation to the vessel
- interruption of blood stream
What is the triad now described as?
- composition of blood
- structural & functional integrity of vessel wall
- blood flow
What site is there a lot of venous thrombosis?
Venous valve
What does hypoxia cause?
Inactivation of hemostatic system -> TF expressed
What does deletion of CLEC2 cause?
Blocks thrombus formation in a mouse model of venous thrombosis
What ligand becomes upregulated in CLEC2 deletion?
Podoplanin
Where is podoplanin expressed?
Subendothelial cell types
When is podoplaninover expressed?
venous thrombosis