Pathophysiology of Thrombosis and Embolism

Question 1

Virchow’s triad

Answer 1

Changes in:
Blood vessel wall
Blood constituents
Pattern of blood flow

Question 2

Thrombosis

Answer 2

Formation of a solid mass from the consistent of blood within the vascular system during life

Question 3

Factors causing thrombosis

Answer 3

Virchow’s triad

Question 4

Pathogenesis of thrombosis

Answer 4

Cause - stasis or turbulent blood flow - hypercoagubility of the blood

Question 5

Alternating bands in thrombus

Answer 5

Lines of Zahn

Question 6

Examples of causes of thrombus

Answer 6

Atheromatous plaque
Hypercholesterolaemia
Aneurysm
Post traumatic hypercoagubility
Economy class syndrome
Post operation

Question 7

Components of a thrombus

Answer 7

Platelets
Fibrin mesh work
Red blood cells

Question 8

Propagation of thrombus

Answer 8

Existing thrombus causes turbulent blood flow which results in more thrombus formation

Question 9

Consequences of thrombus depend on

Answer 9

Site
Extent
Collateral circulation

Question 10

Thrombosis can lead to

Answer 10

Deep vein thrombosis
Ischaemic limb
MI

Question 11

Possible outcomes of thrombosis

Answer 11

Resolution
Organisation/recanalisation
Death
Propagation - embolism

Question 12

Embolism

Answer 12

Movement of abnormal material in the bloodstream and its impaction in a vessel, blocking its lumen

Question 13

Embolus

Answer 13

Detached intravascular solid, liquid or gaseous mass

Question 14

Types of embolus

Answer 14

Systemic/arterial thromboembolus
Venous thromboembolus
Fat
Gas
Tumour
Trophoblast 
Septic material
Amniotic fluid
Bone marrow
Foreign bodies

Question 15

Common sites that systemic thromboembolus travel to

Answer 15

Lower limbs and brain

Question 16

Usual consequence of systemic thromboembolus

Answer 16

Infarction

Question 17

Sources of systemic thromboembolus

Answer 17

Mural thrombus
Aortic aneurysm
Atheromatous plaque
Valvular vegetations

Question 18

Source of venous thromboembolus

Answer 18

Deep vein thromboses (lower limbs)

Question 19

Venous thromboembolus travels to

Answer 19

Pulmonary arterial circulation

Question 20

Consequences of pulmonary thromboembolism

Answer 20

Silent
Pulmonary haemorrhage/infarction
Right heart failure
Sudden death

Question 21

Consequence of many pulmonary embolisms over time

Answer 21

Pulmonary hypertension and right ventricular failure

Question 22

Risk factors for deep vein thrombosis and pulmonary thromboembolism

Answer 22

Cardiac failure
Severe trauma/burns
Post-op/post-partum
Increased age
Bed rest/immobilisation

Question 23

Prophylaxis for surgical patients at risk of thrombosis

Answer 23

TEDS

s/c heparin

Question 24

Effects of fat embolus

Answer 24

Skin rash

Decreasing renal function

Question 25

Decompression sickness

Answer 25

Nitrogen forms as bubbles which lodge in capillaries

Question 26

Mycotic embolism

Answer 26

Embolism due to septic material