ILA thrombosis Flashcards
1
Q
what is the difference between a venous and arterial thrombosis?
A
either blocking an vein or artery respectively
2
Q
according to Virchow’s triad, what 3 factors contribute to formation of a thrombosis?
A
venous stasis, vascular injury, hypercoagulability
3
Q
explain the pathophysiology of thrombus development.
A
- valves inside veins can lower blood oxygen levels →
- Venous stasis associated hypoxemia can activate reactive oxygen species, other hypoxia inducible factors →
- Tissue factor released into blood →
- Activation of tissue factor causes prothrombin to turn into thrombin →
- Fibrin fibres form a net →
- Net traps RBCs, WBCs and platelets →
- Venous thrombus is formed
4
Q
What blood test would you do to help confirm a diagnosis of a DVT? Why does the blood level of this ‘substance’ increase with the presence of a DVT?
A
- D-dimer protein is a by-product that is broken down from a blood clot
- the larger the number of fragments found, the more likely it is that you have a blood clot in your vein
- unreliable - fragments can increase after an operation, injury or during pregnancy
5
Q
explain the actions of heparin
A
- combines with antithrombin and forces a change in the compound so it acts to reduce clotting
- inactivates 2, 8, 9, 10, 11, 12
- encourages release of tissue factor pathway inhibitor (TFPI)
- can be inactivated by nicotine
6
Q
explain the action of warfarin
A
- inhibits enzymatic reduction of vitamin K to active form (hydroquinone)
- vit K dependent clotting factors no longer work -> anticoagulation
7
Q
what is post thrombotic syndrome?
A
- damage to veins / valves post thrombotic event
- symptoms: chronic leg swelling, skin discoloration, leg ulcers
8
Q
advice for someone susceptible to a DVT who is going on a long flight?
A
- move around
- avoid alcohol / sleeping tablets that discourage movement
- keep hydrated
- wear anti-embolism socks
- LMWH
