Patho18(hemodynamics file17) Flashcards
(32 cards)
Causes of thrombosis based on “Virchow triad”?
1) endothelial injuriy
2) abnormal blood flow
3) hypercoagulability
وهم مترابطين كما بالصورة ورح نشوف كيف خلال المحاضرة
How endothelial injury cause thrombosis?
*Severe endothelial injury /may trigger thrombosis by exposing VWF and tissue factor.
*Inflammation and other noxious stimuli also promote thrombosis by
shifting the pattern of gene expression in endothelium to one that is “prothrombotic.”
* Endothelial activation or dysfunction: physical injury, infectious agents, abnormal blood flow, inflammatory mediators, melabolic abnormalities, such as hypercholesterolemia or homocystinemia, and toxins absorbed from cigarette smoke.
how abnormal blood flow cause thrombosis ?
Turbulence (chaotic blood flow) contributes to arterial and cardiac thrombosis by causing endothelial injury or dysfunction, and stasis.
In which conditions or diseases abnormal blood flow happens? And explain each
- Ulcerated atherosclerotic plaques.
- Abnormal aortic and arterial dilations called (aneurysms.)
- Acute myocardial infarction.
- Mitral valve stenosis.
- Atrial Fibrillation.
- Hyperviscosity syndromes.
How hypercoagulability cause thrombosis?
Abnormally high tendency of the blood to clot. By Primary (genetic) /seconday (acquire) disorders
Which disorders will cause this hypercoagulability ( primary,secondary)
Table Hypercoagulable States صورة
What are the morphological characteristics of thrombi?
Thrombi can have grossly (and microscopically) apparent laminations called lines of Zahn; these represent pale platelet and fibrin layers alternating with darker red cell-rich layers. صورة
The difference between arterial and venous thrombi (occlusive,color based on type of cell)
Arterial thrombi are frequently occlusive and rich in platelets. Venous thrombi are almost invariably occlusive and contain more enmeshed red cells. متشابك
What is the term of venous thrombi/ and where we commonly found?
(phlebothrombosis)/ Lower extremities (90% of venous thromboses) , the upper extremities, periprostatic plexus, or ovarian and periuterine veins, and under special circumstances they may be found in the dural sinuses, portal vein, or hepatic vein. أماكن خطيرة وأماكن عادي
What we call a thrombi on heart valves? And what’s the type of it ? And what is the disease in heart that cause it?
Vegetations/ Sterile vegetations and infectious vegetation/ nonbacterial thrombotic endocarditis, verrucous endocarditis (Libman Sacks endocarditis), infective endocarditis.
What are the Fate of the Thrombus?
- Propagation.
- Embolization.
- Dissolution.
- Organization and recanalization.
What are the 2 types of Venous Thrombosis (Phlebothrombosis) based on lower extremities?
- Superficial venous thrombosis (varicosities): occurs inside the saphenous system
- Deep venous thrombosis (DVTs): occurs in the larger leg veins at or above the knee joint
(e.g., popliteal, femoral, and iliac veins)
What are the consequences of superficial venous thrombosis?
these rarely embolize /// they can be painful and can cause local congestion and swelling from impaired venous outflow/// predisposing the overlying skin to the development of infections and varicose ulcers.
What are the consequences of deep venous thrombosis?
more serious because they are prone
to embolize.///may cause local pain and edema, collateral
channels often circumvent the venous obstruction. Consequently, DVTs are
entirely asymptomatic in approximately 50% of patients and are recognized only
after they have embolized to the lungs. ////predisposing factors include congestive heart failure, bed rest, and
immobilization, Trauma, surgery, and burns, pregnancy, Tumors
What is a major cause of arterial thromboses?
Atherosclerosis
Which organs are prone to embolization in arterial thrombosis?
The brain, kidneys, and spleen.
What is disseminated intravascular coagulation (DIC)?
Widespread thrombosis within the microcirculation that may be of sudden or insidious onset.
What happens in disseminated intravascular coagulation (DIC)?
The Widespread microvascular thrombosis consumes platelets and coagulation proteins, and at the same time, fibrinolytic mechanisms are activated.
What is the synonym of (DIC)?
consumptive coagulopathy بسبب طريقة عملها
What are the consequences of disseminated intravascular coagulation (DIC)?
Excessive clotting and bleeding may co-exist in the same patient.
What is an embolism? And often cause?
Detached intravascular solid, liquid, or gaseous mass carried by the blood/tissue dysfunction or infarction.
Where the emboli lodged?
in vessels too small to permit further passage, resulting
in partial or complete vascular occlusion; depending on the site of origin, emboli can arrest anywhere in the vascular tree
embolization in
the pulmonary circulation/ in systemic circulation leads to?
hypoxia, hypotension, and right-sided heart failure/// ischemic necrosis (infarction) of downstream tissues
The pulmonary thromboembolism originates from ? And its responsible for which disease ?
originating from deep venous thromboses (95% of cases, from thrombi within
deep leg veins proximal to the popliteal fossa, from lower leg
uncommon) // The most common form of thromboembolic disease
