Brainscape's Knowledge GenomeTM

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


See full index

Pathological Processes > Session 5 > Flashcards

Session 5 Flashcards

1
Q

Define thrombosis

A

Formation of a solid mass of blood within the circulatory system during life

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

In which vessels can thrombosis occur?

A

Any vessels - arteries or veins

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

What is the name given to the formation of solid mass of blood in a test tube/a cut?

A

Clotting

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

Thrombosis can occur due to abnormalities of… (3)

A

The vessel wall
Blood flow
Blood components

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

What three things can cause abnormalities of the vessel wall and therefore thrombosis?

A

Atheroma
Direct injury
Inflammation

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

What two abnormalities of blood flow can result in the formation of thrombi?

A

Stagnation

Turbulence

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

What three things can result in abnormalities of the components in blood that cause thrombosis?

A

Smoking
Pregnancy
Post-op

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

Name 4 features of arterial thrombi

A

Pale
Granular
Lines of Zahn
Lower cell content

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

Name 4 features of venous thrombi

A

Soft
Gelatinous
Deep red
Higher cell content

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

Name 5 outcomes of thrombosis

A 
Lysis 
Propagation 
Organisation 
Recanalisation 
 Embolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What occurs in lysis of a thrombus? What happens to the blood flow? For which type of thrombi does this occur?

A

There is complete dissolution of the thrombus by the fibrinolytic system

Reestablished

When thrombi are small

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

What is propagation of a thrombus?

A

Progressive spread/enlargement of a thrombus in the direction of blood flow

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

In which direction does propagation occur in the arteries?

In which direction does propagation occur in the veins?

A

Propagates distally

Propagates proximally

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

What happens when there is organisation of a thrombus?

A

There is ingrowth of fibroblasts/capillaries to repair the vessel but the lumen remains obstructed

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

What happens during recanalisation of a thrombus? What happens to blood flow?

A

One or more channels is formed through the organising thrombus

Blood flow is reestablished but incompletely

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

In which direction do emboli travel in the arteries?

In which direction do emboli travel in the veins?

A

Away from the heart

Towards the heart

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

The effects of thrombosis in the arterial system depends on the __________ of the thrombus and the ________________ circulation

A

Site

Collateral

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

Name two effects of thrombosis in the arterial system

A

Ischaemia

Infarction

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

Name 4 effects of thrombosis in the venous system

A

Congestion
Oedema
Ischaemia
Infarction

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

Define embolism

A

The blockage of a blood vessel by solid, liquid or gas at a site distant from its origin

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

Over 90% of emboli are…

A

Thrombi-emboli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Name 5 other types of emboli excluding thrombo-emboli

A 
Air
Amniotic fluid 
Nitrogen 
Medical equipment 
Tumour cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Roughly how much air is needed to cause an air embolism?

What effect does an air embolism have on the blood?

A

~150ml

Makes the blood ‘frothy’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When might nitrogen embolism occur? What happens in nitrogen embolism?

A

During decompression - e.g. Bends

Dissolved nitrogen becomes gaseous nitrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Where do thrombi-emboli from systemic veins end up?

A

In the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Where do thrombi-emboli from the heart usually pass through?

A

The aorta to renal, mesenteric and other arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Thrombo-emboli from atheromatous carotid arteries pass to the…

Resulting in…

A

Brain

Stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Thrombo-emboli from atheromatous abdominal aorta pass to…

Resulting in…

A

The arteries of the legs

Ischaemic limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Thrombo-emboli that pass to the brain usually enter from which vessels?

A

Carotid arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Thrombo-emboli that end up in the arteries of the legs usually enter through which vessel?

A

Abdominal aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Name a few predisposing factors of deep vein thrombosis

The factors result in an increased risk of deep vein thrombosis and therefore…

A 
Immobility/Bed Rest 
Post-Op
Pregnancy 
Disseminated Cancer
Cardiac Failure

Pulmonary embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Give an example of a preventative measure against DVT used in hospitals

A

Flowtron boots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How do Flowtron boots work?

A

Intermittently inflate mimicking the muscle pump of the calves and assisting venous return to the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Name two drugs that are used in the treatment of DVT

Do they dissolve the existing thrombus?

A

IV heparin type drugs
Oral warfarin

No, only prevent their propagation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What reduction in blood flow will be seen in a massive PE? What prognosis does this have for the patient?

A

> 60% reduction

Rapidly fatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What blood vessels are blocked in a major PE? What symptoms may be seen in a patient?

A

Medium sized blood vessels are blocked

Shortness of breath
Cough
Blood stained sputum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Which vessels are blocked in a minor PE? What symptoms can this cause?

A

Small peripheral pulmonary arteries

Asymptomatic/Minor Shortness of Breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Recurrent minor PEs can lead to…

A

Pulmonary hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Fat embolism usually occurs as result of…

A

Long bone fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What happens in fat embolism?

A

There is the release of fat and marrow into the blood (usually as a result of a long bone fracture)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is haemostasis?

A

Stopping of a flow of blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the aims of haemostasis?

A

To prevent bleeding and prevent unnecessary coagulation to allow blood to flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What cells are platelets produced from? Where in the body?

A

Megakaryocytes

Bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

In which way are platelets produced from megakaryocytes?

A

They bud off their cytoplasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the typical platelet count?

What is the typical platelet life span?

A

150-400

7-10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What causes platelet adhesion to take place? How do they adhere?

A

Damage to the vessel wall

Damage to the wall —> Exposure to underlying tissues. Platelets adhere to collagen via vWF receptor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Which receptor do platelets bind to in their adherence to collagen?

A

vWF receptor

48
Q

How do platelets activate other platelets and the clotting cascade to some extent after they adhere?

A

Secrete ADP, thromboxane and others to become activated and activate other platelets

49
Q

What do platelets secrete to activate other platelets? What else do they secrete?

A

ADP, thromboxane etc.

Some coagulation factors from internal stores

50
Q

How is a platelet plug formed?

A

There is aggregation and cross-linking of platelets to form a platelet plug

51
Q

Describe the clotting cascade

A

Amplification activation of precursor proteins to generate thrombin
Thrombin converts soluble fibrinogen to insoluble fibrin
Strengthens initial platelet plug to make the stable clot

52
Q

How is fibrin formed in the clotting cascade?

A

Thrombin converts fibrinogen to fibrin

53
Q

What is the clotting cascade controlled by? (2)

A

Natural anticoagulants

Clot destroying proteins

54
Q

Clotting factors are produced in which part of the body?

A

Liver

55
Q

Give two examples of coagulation factors

A

Fibrinogen

Prothrombin

56
Q

Give two examples of natural anticoagulants

A

Protein C

Protein S

57
Q

What is used to measure the extrinsic pathway and common pathway?

What is used to measure the intrinsic and common pathway?

A

PT

APPT

58
Q

What coagulation factors does PT mainly measure?

A

Factor VII

59
Q

What coagulation factors does APPT mainly measure?

A

Factors VIII, IX, XI and XII

60
Q

Which coagulation factors does both PT/APPT measure?

A

Factors V, X
Prothrombin
Fibrinogen

61
Q

Name three functions of Von Willebrand Factor

A

Platelet adhesion
Platelet aggregation
Carries Factor VIII

62
Q

What three things occur in the vessel wall during injury?

A

Vasoconstriction
Production of vWF
Exposure of collagen and tissue factor which initiates activation of clotting factors

63
Q

What is fibrinolysis?

A

The process of breaking down a clot

64
Q

Describe the process of fibrinolysis

A

Plasminogen activator converts plasminogen to plasmin which breaks down fibrin clot into D-dimers

65
Q

What is the name of the molecule that converts plasminogen to plasmin?

A

Plasminogen Activator

66
Q

What enzyme breaks down a fibrin clot to D-dimers?

A

Plasmin

67
Q

What is the function of natural anticoagulants?

A

Stop further coagulation of blood

68
Q

Give three examples of natural anticoagulants

A

Protein C
Protein S
Anti-thrombin

69
Q

Bleeding disorders can be as a result of abnormalities in the… (3)

A

Vessel wall
Platelets
Coagulation factors

70
Q

Give two examples of congenital coagulation factor disorders

A

Haemophilia A

Haemophilia B

71
Q

Haemophilia A is as a result of which coagulation factor?

A

Deficiency of factor 8

72
Q

Haemophilia B is as a result of which coagulation factor?

A

Deficiency of factor 9

73
Q

Name three acquired conditions that can cause coagulation factor disorders

A

Liver disease
Vitamin K deficiency
Use of anticoagulants such as warfarin

74
Q

How do anticoagulants such as warfarin act as anticoagulants?

A

Inhibit vitamin K

75
Q

Clinical severity of coagulation factor disorder depends on…

A

The extent of the deficiency

76
Q

In which way is haemophilia A inherited?

A

X-linked recessive

77
Q

In haemophilia A there is a congenital lack of factor…

A

8

78
Q

When is haemophilia A diagnosed if congenital?

A

Pre-natally or soon after birth

79
Q

When is haemophilia A diagnosed if it as a result of a spontaneous mutation?

A

Infancy

80
Q

What happens as a result of haemophilia A?

A

Bleeding into muscle and joints

Bleeding post-operatively

81
Q

How is haemophilia A treated? (2)

A

Recombinant factor 8

DDAVP

82
Q

How does haemophilia B present compared with haemophilia A?

A

Similar presentation

83
Q

Which is rarer, haemophilia A or haemophilia B?

A

Haemophilia B

84
Q

What is the cause of haemophilia B?

A

Congenital deficiency in factor IX

85
Q

In which way is Von Willebrand’s disease inherited?

A

Autosomal dominant

86
Q

What does Von Willebrand’s disease result in? (2)

A

Abnormal platelet adhesion to vessel wall

Reduced factor 8 amount/activity

87
Q

Name two parts of the clotting cascade that will be seen at low levels in Von Willebrand’s disease

A

Factor 8

vWF

88
Q

Name two clinical features of someone with Von Willebrand’s disease

A

Skin and mucous membrane bleeding

Prolonged bleeding after trauma

89
Q

Give two examples of skin and mucous membrane bleeding which can take place as a result of Von Willebrand’s disease

A

Nosebleeds

Gum bleeding

90
Q

How does the symptoms of Von Willebrand’s disease differ to haemophilia?

A

In haemophilia there is spontaneous joint/muscle bleeds. There is not in VW disease

91
Q

Vessel wall abnormalities can cause bleeding disorders. What do they typically present with?

A

Easy bruising

92
Q

Give two examples of congenital conditions that cause vessel wall abnormality

A

Hereditary Haemorrhage Telangiectasia (HHT)

Ehlers Danlos

93
Q

In what way is HHT inherited?

A

Autosomal dominant

94
Q

What happens in HHT?

A

There are dilated microvascular swellings that increase with time

95
Q

Name 3 acquired causes of vessel wall abnormalities

A

Senile purpura
Steroids
Scurvy

96
Q

Platelet disorders can be either qualitative or quantitative, what is meant by this?

A

Qualitative - abnormal platelet activity

Quantitative - thrombocytopenia

97
Q

A low platelet count is either a result of…

A

Reduced production

Increased removal

98
Q

What can be carried out to discover the cause of thrombocytopenia?

A

Bone marrow biopsy

99
Q

Give an example of something that can result in increased removal of platelets

A

Splenic pooling

100
Q

What is the most common way for the immune system to destroy platelets?

A

Immune thrombocytopenia purpura

101
Q

What happens in immune thrombocytopenia purpura?

A

Autoantibodies are produced against the glycoproteins on platelets

102
Q

How is immune thrombocytopenia purpura treated?

A

With immunosupression

103
Q

Can platelet transfusions be given to a patient with immune thrombocytopenia purpura? Why?

A

No

These platelets also get destroyed

104
Q

Give an example of a condition where there is non-immune destruction of platelets

A

Disseminated Intravascular Coagulopathy (DIC)

105
Q

Name 4 factors that can result in reduced production of platelets in the bone marrow

A

B12/Folate Deficiency
Infiltration of bone marrow by cancer cells/fibrosis
Drugs
Viruses

106
Q

Give two examples of drugs that can cause reduced production of platelets in the bone marrow

A

Chemotherapy

Antibiotics

107
Q

Give two examples of viruses that can cause reduced production of platelets in the bone marrow

A

HIV

EBV

108
Q

Patients with low platelets are generally asymptomatic until platelet count is less than…

A

30

109
Q

Name 5 symptoms of severe thrombocytopenia

A 
Easy bruising 
Mucosal bleeding 
Severe bleeding after trauma 
Intercranial haemorrhage 
Purpura
110
Q

How common are hereditary disorders of platelet function? Give an example

A

Very rare

Bernard Soulier

111
Q

What can cause acquired disorders of platelet function (3)

A

Aspirin
NSAIDS
Clopidogrel

112
Q

Disseminated intravascular coagulapthy is a type of…

A

Microangiopathic haemolytic anaemia

113
Q

What happens in DIC?

A

Numerous micro thrombi are formed. There is consumption of clotting factors, platelet and haemolytic anaemia.

114
Q

How will PT, APPT, fibrinogen levels and D-dimer levels be affected by DIC?

A

Raised
Raised
Low
Raised

115
Q

In which sorts of patients is DIC seen?

A

Severely ill patients - e.g. Cancer, burns, infections

116
Q

How is DIC treated?

A

Treatment of the underlying cause

Pathological Processes (10 decks)

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