Intro to VTE and Thromboembolic Disease Introduction Flashcards
Thrombosis
Formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system.
Virchows triad.
Three major factors responsible for the development of venous thrombosis.
- Blood stasis (reduced blood flow)
- Vascular injury (collagen is exposed and can activate the coagulation cascade)
- Hypercoagulable state (imbalance between procoagulant and anticoagulant proteins in the blood)
VTE
Venous thromboembolism.
Disease resulting from excessive clot formation as a consequence of disturbed coagulation equilibrium.
VTE refers to ____ and ___
DVT and PE
Proximal DVT refers to thrombosis of the deep beings of the leg at the level of the ____ vein or above
Popliteal vein
Distal DVT refers to thrombosis of the deep veins blow the level of the knee. Sometimes blood clots can be superficial, called ___ ____ and aren’t as serious
Superficial thrombophlebitis.
Causes of “stasis”
Immobility, venous obstruction, increased venous pressure, increased viscosity
Hypercoagulable state can be due to deficiencies of natural anticoagulants such as:
Antithrombin protein C, protein S.
Hypercoagulable state can be due to upregulatin of production of coagulant proteins, or decreased sensitivity to action of natural anticoagulants, like ____
Factor 4 Leiden.
Hypercoagulbility can be due to genetic causes of acquired causes like APLA, malignancy, trauma, burns, drugs.
Name some week, Mild, moderate and strong ACQUIRED risks to VTE
Weak; smoking and diabetes
Mild: pregnancy, ocp, Hart, obesity, long haul travel, MI, heart failure
Moderate; APLA, non major surgery, malignancy
Strong: major surgery, poly trauma, central venous catheters
Someone with APLA requires life long anticoagulant therapy
Genetic risks to VTE
VTE= thrombosis issues like DVT and PE. Defieiciencies in things that cause clot breakdown would increase the likelihood of VTE
- protein S deficiency
- protein C deficiency
- factor 5 Leiden.
- antithrombin def
- non-O blood gro9up
- prothrombin mutaiton
Why does the presence of factor 5 Leiden predispose someone to VTE issues
Leiden makes factor 5 more resistant to protein C inactivation
When should you screen for thrombophilias
- Individuals with first VTE before 40-45
- VTE at any age with a strong family history of thrombotic disease
- VTE in an unusual site (hepatic, mesenteric, portal,cerebral vein)
When is the best time to test for thrombophilias
1 month after completion of anticoagulant therapy