Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular > Pathophysiology of Thrombosis and Embolism > Flashcards

Pathophysiology of Thrombosis and Embolism Flashcards

1
Q

What effects the normal blood flow?

A

Pressure gradient, resistance, viscosity of blood, velocity and compliance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is normal blood flow described as?

A

Laminar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 2 types of abnormal blood flow?

A

Stasis - stagnation of flow
Turbulence - forceful and unpredictable flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can cause defects in blood flow?

A

Thromboembolism
Atheroma
Hyper-viscosity, spasm, external compression, vasculitis and vascular steal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Virchow’s Triad?

A

Changes in blood vessel wall
Changes in blood constituents
Changes in the pattern of blood flow
These are factors that cause thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is thrombosis?

A

Formation of solid mass from the constituents in blood within the vascular system
Due to Virchow’s triad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is an example of a change in vessel wall?

A

Atheromatous coronary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the pathogenesis of thrombosis?

A

Endothelial injury
Stasis or turbulent blood flow
Hypercoagulability of the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does an atheroma lead to thrombosis?

A

Turbulent blood flow, loss of intimal cells and denuded plaque, collagen is exposed and platelets adhere, fibrin meshwork, RBCs trapped (lines of Zahn)
Further turbulence and platelet deposition - propagation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does hypercholesterolaemia cause thrombosis?

A

Change in blood constituents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does propagation of thrombus happen?

A

Thrombus causes more turbulent flow so causes more platelet deposition and fibrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is an example of a change in the vessel wall causing thrombosis?

A

LV wall is thin so if MI can cause dilatation of ventricle
Neural thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some examples in changes in the blood constituents?

A

Hyper-viscosity, post-traumatic hypercoagulability
Stasis - post op, economy class syndrome
Turbulence - atheromatous plaque and aortic aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do the consequences of a thrombus depend on?

A

Site
Extent
Collateral circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some common clinical scenarios of thrombosis?

A

DVT, ischaemic limb and MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the outcomes for thrombosis?

A

Resolution
Organisation/ recanalisation (thrombolysis)
Death
Propagation and possible embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe an embolism

A

Movement of abnormal material in the bloodstream and its impaction in a vessel which blocks its lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is an embolus?

A

Detached intravascular solid, liquid or gaseous mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What could be the sources for systemic/arterial thromboembolism?

A

Mural thrombus - MI, LA dilatation or atrial fibrillation
Aortic aneurysm, atheroma, valvular vegetations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a paradoxical emboli?

A

Happens due to venous thrombi
If cardiac defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Explain systemic thromboembolism

A

Travel to wide variety of sites - lower limbs most common, brain..
Consequences depend on the vulnerability of tissues to ischaemia, occluded vessels and collateral circulation - usually infarction

22
Q

Explain venous thromboembolism

A

Originated from deep venous thromboses (lower limbs)
Most common form
Travels to pulmonary arterial circulation
Often multiple

23
Q

What happens if there is a big venous thromboembolism?

A

Can occlude main pulmonary artery and bifurcation -saddle embolus

24
Q

What are some consequences of venous thromboembolism?

A

Silent, pulmonary haemorrhage, infarction, right heart failure and sudden death

25
Q

What happens if there are multiple PE over time?

A

Pulmonary hypertension
Right ventricular failure

26
Q

What are the risk factors for DVT and pulmonary thromboembolism?

A

Cardiac failure, severe burns, post-op/partum, nephrotic syndrome, disseminated malignancy, oral contraception, age, bed rest, obesity, PMH of DVT

27
Q

What is given to patients who are at risk of Thromboembolism or DVT?

A

Prophylaxis - TEDS, heparin (anticoagulation measures)

28
Q

What is a fat embolus?

A

Can happen after major fractures - fat breaks off
Syndrome of fat embolism - brain, kidneys and skin affected

29
Q

Explain gas embolus

A

Decompression sickness if rise to surface too quickly
N2 forms as bubbles which lodge in capillaries

30
Q

Explain air embolus

A

Head and neck wounds, surgery, and CV lines
Air is introduced to bloodstream

31
Q

What is a tumour embolus?

A

Spread of tumour
Tumour can break off and go into bloodstream and possibly grow as well as occlude

32
Q

When does trophoblast embolus occur?

A

In pregnant women - lungs
Is very rare

33
Q

Describe amniotic fluid embolus?

A

Skin cells or keratin from baby can break off and usually go to lungs of mother
Can be very serious for mother - cause collapsing

34
Q

What are some other types of embolus?

A

Bone marrow
Foreign bodies
Septic material

35
Q

What is rheumatic fever?

A

Is a disease of disordered immunity
Is inflammatory changes in the heart, joints and sometimes neurological symptoms

36
Q

Who does rheumatic fever usually affect?

A

Children between 5-15 years
Usually boys over girls

37
Q

What is the presenting features of rheumatic fever?

A

Flitting (painful) polyarthritis of large joints (wrists, elbows, knees and ankles) plus skin rashes and fever
Pancarditis in acute phase and heart murmurs are common

38
Q

What is pancarditis?

A

Inflammation affecting the endocardium, myocardium and pericardium

39
Q

What infection are patients with rheumatic fever usually exposed to?

A

Group A beta-haemolytic streptococci infection

40
Q

How does strep. infection lead to rheumatic fever?

A

Strong antibody reaction to strep. - may cross react with unknown antigens in connective tissue
Damage to heart tissue may be caused by combination of antibody-mediated and T-cell mediated reactions

41
Q

Explain an Aschoff Body

A

Seen in heart of acute rheumatic fever
Focus of chronic inflammatory cells, necrosis and activated macrophages (antischkow cells)

42
Q

What are some causes of valvular heart disease?

A

Valvular stenosis
Valvular incompetence/regurgitation
Vegetations

43
Q

What is valvular stenosis?

A

Valve thickened/calcified and obstructs normal blood flow into chamber/ vessel

44
Q

What is valvular incompetence or regurgatation?

A

Valve loses normal function and fails to prevent reflux of blood after contraction of cardiac chamber

45
Q

What is vegetations?

A

Infective or thrombotic nodules develop on valve leaflets impairing normal valve mobility - may embolise

46
Q

What does chronic rheumatic heart disease usually manifest as?

A

Valvular abnormalities

47
Q

What does inflammation of endocardium and left sided valves result in?

A

Fibrinoid necrosis of valve or cusps/ chordae tendinea, over which form small vegetations

48
Q

Explain rheumatic heart disease?

A

Characterised by deforming fibrotic valvular disease - involving the mitral valve
Typically leaflet thickening, commissural fusion and shortening, thickening and fusion of chordae tendineae

49
Q

What does rheumatic heart disease cause?

A

Mitral stenosis
Mitral regurgitation is rare
Aortic stenosis and regurgitation is rare
Pulmonary valve and tricuspid is rare

50
Q

What is the appearance of mitral valve in rheumatic heart disease?

A

Fish mouth appearance
Very thin and stenosed

Cardiovascular (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions