Lecture 5- Thromboembolic Disease 8/31 Flashcards
A… is an intravascular clot often impeding or preventing blood flow and … is the formation or presence of a thrombus that may result in infarction
thrombus
thombosis
The components of Virchows triad are
- endothelial injury
- alt. in blood flow
- hypercoagulability
Alteration in blood flow can be either… or … which both cause endothelial activation
stasis
turbulence
Endothelial injury leads to a loss of …. and increase in…. activity
barrier
prothrombotic
Hypercoagulability can be an … or … condition
inherited
acquired
3 inherited conditions of hypercoagulability are…
Factor V leiden
Prothrombin mutation
ATIII deficiency
5 acquired conditions of hypercoagulability
- prolonged bed rest
- extensive tissue injury
- pregnancy
- cancer
- anti- PL ab
Thrombosis on the arterial side results in a thrombus that is … which can be occlusive or mural and has … lines of Zahn
white
distinct
Thrombosis on the venous side results in a thrombus that is … and has…. lines of Zahn
red
indistinct
4 possible fates of thrombi
- propagation
- embolization
- dissolution
- organization/recanalized
… is the widespread activation of the coag cascade and fibrinolytic systems
Disseminated intravascular coagulation
DIC is called a “… coagulopathy”
consumptive
DIC results in the depletion of … and … and the elevation of … products leading to both … and …
coagulation factors platelets fibrin split microthrombi hemorrhage
5 etiologies of DIC
- infection (gram neg bact)
- obstetric complications
- neoplasm
- shock
- massive tissue injury
The treatment for DIC is highly … and dependent upon management of ….
variable
underlyind disorder
DIC is potentially ….
life-threatening
An … is an intravascular solid, liquid, or gaseous mass carried by the blood to a site distant from its point of origin
embolus
The vast majority of emboli are …
dislodged thrombus material (thromboembolism)
the origin of a pulmonary thromboembolism is usually from a
deep leg vein
5 possible clinical consequences of pulmonary thromboembolism
- no manifestations
- pulmonary hemorrhage
- pulmonary infarction
- sudden death (saddle embolus)
- pulmonary HTN
The origin of a systemic embolization is either …, … or …
LA
LV
atherosclerotic plaque
A paradoxical systemic embolus is when the embolus arises in a … then crosses into the … side often through a ….
vein
arterial
patent foramen ovale
5 types of embolism
air fat amniotic fluid thrombus atherosclerotic plaque material
an … is an area of ischemic necrosis secondary to occlusion of arterial supply or venous drainage. this is a major contributor to mortality assoc. with CV dz
infarction
4 factors that influence infarct development
- nature of vascular supply
- rate of occlusion
- vulnerability to hypoxia
- O2 carrying capacity of CV system
…. is systemic hypoperfusion
shock
5 pathophysiologic categories of shock
cardiogenic hypovolemic septic (endotoxin) anaphylactic neurogenic
…. is the #1 cause of death in ICUs (… annually in the U.S.) 20% mortality
septic shock
200,000
3 stages of shock
nonprogressive
progressive
irreversible
… shock is when compensatory mechanisms maintain perfusion
nonprogressive
… shock is when there is inadequate perfusion, lactic acidosis, DIC, anaerobic metab.
progressive
… shock is when tissue injury is unrecoverable, multiple organ failure, death occurs
irreversible
9 clinical manifestations of shock
tachypnea tachycardia confusion low UO acidosis high lactic acid hypotension cool clammy skin pallor/cyanosis
