Haemostasis, Thrombosis And Embolism

Question 1

What converts fibrinogen to fibrin?

Answer 1

Thrombin

Question 2

Name some thrombin inhibitors

Answer 2

Anti-thrombin III
Alpha 1 anti-trypsin
Alpha 2 macroglobulin
Protein C and S

Question 3

What are the 2 widely used fibrinolytic therapies?

Answer 3

Streptokinase

tPA (tissue plasminogen activator)

Question 4

What anti-thrombotic substances are released from the endothelium?

Answer 4

Plasminogen activators
Prostacyclin
Nitric oxide
Thrombomodulin

Question 5

Define thrombosis

Answer 5

The formation of a solid mass of blood within the circulatory system during life.

Question 6

What are the components of Virchow’s triad for thrombosis?

Answer 6

Abnormalities of vessel wall
Abnormalities of blood flow
Abnormalities of blood components

Question 7

Describe the appearance of an arterial thrombus

Answer 7

Pale
Granular
Lines of Zahn
Lower cell content

Question 8

Describe the appearance of a venous thrombus

Answer 8

Soft
Gelatinous
Deep red
Higher cell content

Question 9

What are the possible outcomes of thrombosis?

Answer 9

Lysis
Propagation
Organisation 
Recanaliastion 
Embolism

Question 10

Define propagation of a thrombus

Answer 10

Progressive spread in the direction of blood flow

Question 11

Describe organisation of a thrombus

Answer 11

Reparative process with an ingrowth of fibroblasts and capillaries
Lumen remains obstructed

Question 12

What is a hyperaemic zone?

Answer 12

A junction between dead and alive tissue

Question 13

Define embolism

Answer 13

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

Question 14

Apart from breaking off a thrombus, what can emboli be?

Answer 14

Air
Amniotic fluid
Nitrogen 
Medical equipment
Tumour cells

Question 15

Name some risk factors for DVT

Answer 15

Immobility 
Post-op
Post-partum/pregnancy 
Oral contraceptives 
Severe burns
Cardiac failure 
Disseminated cancer

Question 16

What can we do to prevent DVT?

Answer 16

Move regularly if possible
Subcutaneous heparin
Leg compression stockings

Question 17

What is the treatment for DVT?

Answer 17

IV heparin

Oral warfarin

Question 18

When could a fat embolism occur?

Answer 18

After a long bone fractures as the bone marrow can get into the circulation

Question 19

Damage to endothelium releases …

Answer 19

vWF

Question 20

Describe a paradoxical embolism

Answer 20

If the patient has a septal defect in the heart and they are straining/coughing then an embolism may move through the defect (right to left) and travel to the brain.

Question 21

Haemophilia A is a deficiency in …

Answer 21

Factor VIII

Question 22

Haemophilia B is a deficiency in …

Answer 22

Factor IX

Question 23

What is the inheritance pattern of haemophilia A and B?

Answer 23

X linked recessive

Question 24

What is a saddle embolism?

Answer 24

The embolism gets impacted across the bifurcation of the pulmonary artery.

Question 25

When is an air embolism most likely to occur?

Answer 25

Dissolved nitrogen comes out of solution in divers during rapid decompression

Question 26

Thrombocytopenia is a deficiency of …

Answer 26

Platelets

Question 27

What is thrombophilia?

Answer 27

Hereditary defect leading to a lifelong tendency to thrombosis

Question 28

Define stricture

Answer 28

An abnormal narrowing of a body passage

May be due to scar tissue or a tumour

Question 29

Which cells are platelets fragments of?

Answer 29

Megakaryocytes