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MoD > haemostasis and thrombosis > Flashcards

haemostasis and thrombosis Flashcards

1
Q

What pathway does activated partial thromboplastin time (APTT) involve?

A

intrinsic

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2
Q

How can disorders of coagulation and haemostasis arise

A

Inherited-single gene mutations
acquired

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3
Q

How can platelets be affected

A

bnormal number of platelets
Abnormal function of platelets
Or both

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4
Q

What pathway does prothrombin time (PT) involve?

A

extrinsic

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5
Q

In what direction does thrombosis progress in veins

A

proximally

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6
Q

In what direction does thrombosis spread in arteries

A

distally

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7
Q

What 2 clotting screening tests are there

A

prothrombin time (PT)

Activated partial thromboplastin time (APTT)

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8
Q

What 2 genetically determined conditions increase risk of thrombosis

A

Factor V Leiden

Protein C deficiency

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9
Q

What activates Inactive FXIII

A

Thrombin IIa

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10
Q

What are DVT and PE collectively known as

A

Venous thromboembolism(VTE)

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11
Q

What are lines of Zahn

A

characteristic of thrombi that appear particularly when formed in the heart or aorta

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12
Q

What are some characteristics of arterial thrombi

A

Pale/red
granular
lines of Zahn

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13
Q

What are some examples of direct Xa inhibitors

A

Rivaroxaban
apixaban
edoxaban

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14
Q

What are some mechanical methods to prevent deep vein thrombosis - DVT

A

Anti-embolism stockings
intermittent pneumatic compression
foot impulse devices

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15
Q

What are some risk factors for arterial thrombosis(8)

A

Age
smoking
obesity
hypertension
atherosclerosis
diabetes
south asian
hypercholesterolaemia

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16
Q

What are some risk factors for VTE (Venous thromboembolism)(5)

A

age
malignancy
trauma
pregnancy
immobility

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17
Q

What are the 2 types of thrombosis

A

arterial and venous

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18
Q

What are the 3 classes of fibrinolytic drugs

A

Tissue plasminogen activator (t-PA)
Streptokinase
urokinase

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19
Q

What are the 3 components of virchow’s triad

A

Endothelial injury
hypercoagulability
stasis (pooling) of blood flow

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20
Q

What are the 3 stages of haemostasis

A

Primary haemostasis
secondary haemostasis
dissolution of clot and vessel repair (fibrinolysis)

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21
Q

What are the 4 core components of haemostasis

A

Vessel wall
platelets
coagulation system
fibrinolytic system

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22
Q

What are the most common thrombosis disorders

A

Deep vein thrombosis (DVT)
Pulmonary embolism(PE)

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23
Q

What are the different blood tests that can be done for haemostasis

A

full blood count
prothrombin time(PT)
activated partial thromboplastin time(APTT)

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24
Q

What are the different severities of pulmonary embolisms

A

Massive PE
major PE
Minor PE

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25
Q

What are the different types of embolism that can occur

A

Air
Nitrogen
fat
amniotic fluid (only in pregnancies)

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26
Q

What are the effects of arterial thrombosis

A

Ischaemia and infarction

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27
Q

What are the effects of venous thrombosis

A

Congestion
oedema
haemorrhage

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28
Q

What are the most common type of emboli

A

thrombo-emboli

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29
Q

What are the problems with warfarin

A

Need monitoring of INR with frequent blood tests
Dose sensitive

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30
Q

What can inhibit tissue factor in extrinsic coagulation pathway

A

Tissue factor pathway inhibitor

31
Q

What clotting cascade affected in haemophilia

A

Intrinsic pathway

32
Q

What coagulation inhibititors do endothelial cells produce

A

NO (nitric oxide)
Prostacyclin

33
Q

what condition can arise from recurrent minor Pulmonary embolism

A

pulmonary hypertension

34
Q

What do endothelial cells secrete in blood vessel wall injury

A

Von Willebrand factors

35
Q

What does activated partial thromboplastin time measure

A

Instrinsic pathway

36
Q

What does antithrombin III inhibit

A

Thrombin and FXa

37
Q

What does the prothrombin time test measure

A

Extrinsic clotting pathway

38
Q

What factors are cleaved by Protein C

A

Factor Va and VIIIa

39
Q

What is a embolism

A

Blockage of a blood vessel by a solid,liquid or gas at a site distant from its origin

40
Q

What is a major pulmonary embolism

A

Medium sized vessels blocked

41
Q

What is a minor Pulmonary embolism

A

Small peripheral pulmonary arteries blocked

42
Q

What is an example of a direct thrombin inhibitor

A

Dabigatran

43
Q

What is DIC (disseminated intravascular coagulation)

A

Blood clots form throughout the body blocking small blood vessels

44
Q

What is haemarthrosis

A

condition that arises due to bleed into joint cavity

45
Q

What is included in the balance in haemostasis

A

Procoagulant factors
anticoagulant factors

46
Q

What is leukocytosis

A

white blood cell count is above normal range in blood, is a sign of inflammatory response

47
Q

What is massive pulmonary embolism

A

60% reduction in blood flow due to embolism

48
Q

What is primary haemostasis

A

Formation of unstable platelet plug

49
Q

what is pulmonary thromboembolism

A

blood clot lodged in artery in lung hence blocking blood flow to part of lung

50
Q

What is sagittal sinus thrombosis

A

presence of blood clot in dural venous sinuses

51
Q

what is secondary haemostasis

A

stabilisation of plug with fibrin in blood coagulation system

52
Q

What is the characteristic of thrombosis of the femoral artery

A

White bloodless limb

53
Q

what is the D-Dimer test

A

Blood test that can be used to diagnose thrombosis by measuring levels of D-Dimer in the blood

54
Q

What is the function of warfarin

A

Inhibit hepatic synthesis of Factor II,VII,IX and X

It is a vitamin K antagonist hence inhibit production of Vitamin K dependant clotting factors

55
Q

What is the process of platelet plug formation

A

Platelets adhere to subendothelial structures via von Willebrand factors

platelets adhere to one another and the plug is held by insoluble fibrin

56
Q

What is the Well’s Score ?

A

Scoring system that assesses probability of PE with given presentations

57
Q

What is the Well’s Score ?

A

Scoring system that assesses probability of PE with given presentations

58
Q

What is thrombophilia

A

Imbalance in blood clotting proteins or clotting factors

59
Q

what is thrombosis

A

Formation of a solid mass of blood clot within circulatory system

60
Q

What is treatment for classic Haemophillia

A

Recombinant FVIII

61
Q

What is treatment for VTE

A

IV heparin
warfarin
direct oral anticoagulants

62
Q

What is Virchow’s triad

A

three broad categories of factors that contribute to thrombosis

63
Q

What occurs in DIC(Disseminated intravascular coagulation)

A

clotting cascade accelerated
clotting factors consumed faster than they can be replaced

64
Q

What occurs in lysis stage of thrombosis

A

Complete dissolution of thrombus
fibrinolytic systems become active

65
Q

What occurs in organisation stage of thrombosis

A

Growth of fibroblasts and capillary proliferation

66
Q

What occurs in propagation stage of thrombosis

A

Progressive spread of thrombosis

67
Q

What occurs in recanalisation stage of thrombosis

A

One or more channels form through the thrombus
blood flow becomes re-established

68
Q

What occurs in thrombotic thrombocytopaenic purpura

A

Platelet masses form in small vessels leading to a haemorrage and purpura

69
Q

What scoring system used to assess probability of DVT

A

Wells score

70
Q

Where can a embolism from aorta travel to

A

Renal
mesenteric

71
Q

Where can an embolism from carotid arteries travel to

A

brain

72
Q

Where can embolism of abdominal aorta travel to

A

Legs

73
Q

where does purpuric (small blood vessels) bleeding occur

A

kidney
skin
brain
gut
heart

74
Q

Why do we need anti-thrombotics

A

Prevent arteries and capillaries being constantly blocked

Inhibit strokes and heart attacks

MoD (8 decks)

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