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S2 Case 6 - stroke & anticoagulation > Pathophysiology of Coagulation + Haemostasis > Flashcards

Pathophysiology of Coagulation + Haemostasis Flashcards

1
Q

What is thrombosis?

A

Pathological formation of a intravascular blood clot

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2
Q

What are the 3 things that cause thrombosis?

A

Disruption of blood flow (stasis)
Endothelial cell damage
Hypercoagulable states

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3
Q

What may cause disruption to blood flow?

A

Immobilisation (flight, bedrest)
Cardiac wall dysfunction
Aneurysm
AF

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4
Q

What may cause endothelial cell damage?

A

Inflammation
Cigarette smoke
Cytokines
Atherosclerotic plaque

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5
Q

What may cause hypercoagulable states?

A

Any disease process that leads to an increased blood clot formation

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6
Q

What are hypercoagulable states because of?

A

Excessive procoagulant factors or defective anticoagulant

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7
Q

What are hypercoagulable states?

A

Inherited or acquired disease

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8
Q

What is the classic presentation of hypercoagulable states?

A

Recurrent DVT or DVTs at young age

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9
Q

What does Alteplase do?

A

Break down clots

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10
Q

When should Alteplase be used after an ischaemic stroke?

A

Only if it can be within 4.5hrs of symptom onset

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11
Q

What is the 1st choice for the treatment of a venous thrombus?

A

Rivaroxaban
Apixaban

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12
Q

What are venous clots the most common cause of?

A

Stasis of blood

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13
Q

Where is the most common site for venous thrombus?

A

Deep veins on lower limb

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14
Q

What are venous thrombus mostly made of?

A

Fibrin

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15
Q

What are arteriole thrombus mostly made of?

A

Platelets

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16
Q

What are arteriole thrombus mostly due to?

A

Endothelial damage

17
Q

Why is aspirin used for arteriole thrombus?

A

As it is an inhibitor of platelet aggregation

18
Q

What is an embolism?

A

Blockage caused by anything that breaks off = emboli

19
Q

What is a pulmonary embolism?

A

Intravascular mass that travels + occludes pulmonary blood vessels

20
Q

What are the functions of thrombin?

A

Acts on fibrinogen to produce fibrin monomers
Activates 13a
Strengthens blood clot

21
Q

What are the functions of plasmin?

A

Breaks down clot

22
Q

How does plasmin break down the clot?

A

Cleaves fibrin + fibrinogen into FDPs
= form fragments = D-dimers

23
Q

What is thrombin switched off by?

A

Natural anticoagulant antithrombin3
= limits clot formation

24
Q

What are the 3 main stages of platelet aggregation?

A

Adhesion
Release reaction
Aggregation

S2 Case 6 - stroke & anticoagulation (7 decks)

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