haemostasis and thrombosis

Question 1

why is thrombosis multi-causal

Answer 1

interacting genetic and acquired risk factors (increase with age)

Question 2

risk factors of thrombosis

Answer 2

age, pregnancy, immobilised limbs, oral contraceptives, malignancy, surgery, inflammatory response

Question 3

Virchow’s triad of 3 broad categories that contribute to thrombosis

Answer 3

stasis (arterial and venous), hypercoagulability (venous), endothelial injury (arterial)

Question 4

causes of hypercoagulability

Answer 4

anticoagulant deficiency, increased coagulant proteins

Question 5

examples of deficient anticoagulant proteins

Answer 5

antithrobin, protein C, protein S

Question 6

examples of increased coagulant proteins

Answer 6

FVIII, FII, FV Leiden (hereditary polymorphic defects in Caucasians to make resistant to protein C), thrombocytosis (increased platelets)

Question 7

cause of endothelial injury

Answer 7

inflammation expression

Question 8

what lead to overexpression of thrombomodulin and tissue factors

Answer 8

malignancy, infection, immune disorders

Question 9

cause of stasis (reduced blood flow)

Answer 9

surgery, fracture, long haul flight, bed rest

Question 10

what is thrombolysis

Answer 10

use of plasminogen activator tPA to lyse fibrin (high risk of bleeding)

Question 11

3 ways to limit recurrence of thrombosis of production of emboli

Answer 11

anticoagulant therapy (e.g. heparin), lower procoagulant factors (e.g. warfarin), inhibit procoagulant factors (e.g. rivaroxaban)

Question 12

how to prevent risk of venous thromboembolism in hospital

Answer 12

assessment of individual risk (VTE risk assessment) and giving prophylactic antithrombotic therapy e.g. heparin/stockings