Exam 2 - thrombo disorders Flashcards
sequence for primary hemostasis
platelet adhesion, activation, aggregation
secondary hemostasis
coagulation cascade that leads to a fibrin clot
intrinsic pathway
involves Factors XI, IX–>VIII/X
extrinsic pathway
involves TF, Factor VII –>X
common pathway
starts with Factor X–>fibrin clot
4 inhibitors of the coagulation cascade
AT (antithrombin III), PC (protein C), PS (protein S), PAI (Plasminogen activator inhibitor)
venous thrombosis
“red clots”- composition is almost entirely fibrin and erythrocytes with small platelet head; can form in any part of venous system, usually in response to either venous stasis or vascular injury
3 components of Virchow’s triad
Vascular injury, stasis, hypercoagulability
Examples of Venous thrombosis
DVT, PE
Arterial thrombosis
“white clots” - platelets + fibrin in areas of rapid blood flow in response to an injured or abnormal vessel wall
examples of arterial thrombosis
MI, CVA, TIA
Trauma
Transient
Major orthopedic surgery
Transient
Major medical illness
Acquired
Major surgery
Transient
Paralysis/immobility
Acquired
Obesity
Acquired
Varicose veins
Acquired
Malignancy
Acquired
IBD
Acquired
Hormone therapy
Transient
Pregnancy
Transient
APA syndrome
Acquired
Factor V Leiden
Inherited
Protein C deficiency
Inherited
Protein S deficiency
Inherited
Antithrombin III deficiency
Inherited
DVT defintion
thrombus that forms in venous
PE definition
an embolism that usually arises from a thrombus in the venous system that dislodges and then lodges in the pulmonary vasculature causing complete or partial obstruction of blood flow
diagnostic criteria for VTE
Clinical manifestations, risk factor assessment, objective tests, hyper coagulable work-up
indications for Hypercoagulable work-up
<40 y/o and idiopathic
manifestations of DVT: location
can occur in any vein (usually lower extremities; distal or proximal (knee)
manifestations of DVT: Sx
edema, tenderness, pain, erythema, warmth, often unilateral
manifestations of DVT: physical exam
palpable cord, homan’s sign: + if pain behind the knee or calf upon dorsiflexion of the foot
manifestations of DVT: complications
Acute: PE, limb viability
Chronic: recurrent VTE, post-thrombotic syndrome