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Year 3- Specialties > Haematology- Thrombotic Disorders > Flashcards

Haematology- Thrombotic Disorders Flashcards

1
Q

What makes up Virchow’s triad?

A

Stasis of blood
Vessel damage
Hypercoagulability

->Virchow’s triad contributes to thrombus formation leading to a clot

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2
Q

What can cause stasis of blood?

A

Bed rest
Travel

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3
Q

What can cause hypercoagulability of blood?

A

Pregnancy
Trauma

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4
Q

What can cause vessel damage?

A

Atherosclerosis

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5
Q

What are the three elements of haemostasis?

A

Primary haemostasis
Blood coagulation
Fibrinolysis

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6
Q

What are the three steps of primary haemostasis?

A

Vasoconstriction
Platelet adhesion
Platelet aggregation

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7
Q

What are the two steps of coagultion?

A

Insoluble fibrin formation
Fibrin cross-linking

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8
Q

What is an arterial thrombus?

A

A clot made of platelets and fibrin
Results in ischaemia and infarction

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9
Q

What does an arterial thrombus usually occur secondarily to?

A

Atherosclerosis

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10
Q

There are different risk factors for venous and arterial thrombosis.

What are the risk factors for arterial thrombsosi?

A

Age
Smoking
Sedentary lifestyle
Hypertension
Diabetes
Obesity
Hypercholesterolaemia

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11
Q

What are some examples of conditions which are caused by arterial thromboembolism?

A

MI
Unstable angina
Stroke/TIA
Limb ischemia

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12
Q

Primary prevention of arterial thromboembolism?

A

Lifestyle modification
Treatment of vascular risk factors

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13
Q

What is the management for an acute presentation of an arterial thromboembolism?

->e.g. seen in stroke, MI, etc.

A

Thrombolysis
Antiplatelet/anticoagulant drugs

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14
Q

Which factors cause venous thrombus?

A

Stasis and hypercoagulability of blood

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15
Q

What are some specific types of venous thromboembolism?

A

Limb deep vein thrombosis
Pulmonary embolism

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16
Q

Risk factors for venous and arterial thrombosis differ.

What are some of the risk factors for venous thrombosis?

A

Increasing age
Pregnancy
Hormonal therapy e.g. COCP, HRT
Tissue trauma
Immobility
Surgery
Obesity
Systemic disease
FH

17
Q

Name some systemic diseases which increase risks of venous thrombosis.

A

Cancer
Myeloproliferative Neoplasm (MPNs)
Autoimmune disease e.g. IBD, connective tissue disease (SLE), antiphospholipid syndrome

->antiphospholipid syndrome increases risks of both venous and arterial thrombosis

–> also, pretty sure Amy Dowden had a PE when she was recovering from breast cancer so that’s useful to remember

18
Q

How is a diagnosis of venous thrombosis made?

A

D-Dimer
Imaging- Doppler US

Pretest probability scoring: Wells score or Geneva score

->issue with D-dimer is it can be raised in other conditions e.g. cancer, infection. D-Dimer usually done after pretest probability

19
Q

Which investigation is good in the diagnosis of PE?

A

V/Q scan (ventilation/perfusion scan)

CT Pulmonary Angiogram can also be used

20
Q

Which drugs are used om the management in venous thrombosis?

A

Anticoagulants- LMWH, warfarin, DOACs

21
Q

When may thrombolysis be used in management of venous thrombosis?

A

Only in selected cases e.g. massive PE

22
Q

Give some examples of DOACs.

A

Apixaban
Rivaroxaban

->most widely used anticoagulants

23
Q

Which patients would require warfarin rather than DOACs as anticoagulants?

A

Patients with metallic heart valves
Renal failure
Anti-phospholipid syndrome

24
Q

Why is thrombolysis only really used in arterial thrombosis?

A

High risk of bleeding- benefits outweigh risks for arterial thrombosis but not venous thrombosis

25
Q

Heritable thrombophilia?

A

An inherited predisposition to venous thrombosis

->majority are not predictive of recurrent event. Screening of asymptomatic family members is not recommended.

26
Q

What are microvascular thrombus composed of?

A

Platelets and /or fibrin

27
Q

What does microvascular thrombus result in?

A

Diffuse ischaemia

->principally in Disseminated Intravascular Coagulation (DIC)

28
Q

Which conditions can DIC occur in?

A

Septicaemia
Malignancy
Eclampsia

29
Q

What does DIC cause to happen?

A

Gangrene
Organ failure

30
Q
A

Year 3- Specialties (26 decks)

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