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Mechanisms Of Disease > Session 5 > Flashcards

Session 5 Flashcards

1
Q

What is Haemostasis?

A

The bodys response to stop bleeding and loss of blood

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2
Q

What does successful Haemostasis depend on?

A

Vessel wall
Platelets
Coagulation system
Fibrinolytic system

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3
Q

How do blood vessels aid Haemostasis?

A

They construct to limit blood loss

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4
Q

How do platelets aid Haemostasis?

A

They adhere to the damaged vessel wall and to each other

Form a platelet plug

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5
Q

How can the coagulation system be regulated?

A

Thrombin is positive feedback for factor V, VIII and XI

Anti thrombin III and alpha 1 anti trypsin are inhibitors

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6
Q

What can cause thrombosis?

A

An inherited deficiency in antithrombin III

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7
Q

What is fibrinolysis?

A

The breakdown of fibrin by plasmin

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8
Q

When is fibrinolytic therapy used?

A

Used as clot busters eg coronary artery occlusion

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9
Q

What is thrombosis?

A

The formation of a solid mass of blood within the circulatory system during life.

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10
Q

What is Virchow’s Triad?

A

Changes in blood flow
Changes in vessel wall
Changes in blood components
All can lead to a thrombsis.

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11
Q

What are the features of an Arterial thrombi?

A

Pale
Granular
Lines of Zahn
Low cell content

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12
Q

What are the features of a Venous thrombi?

A

Deep red
Soft
Gelatinous
High cell content

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13
Q

What are some of the effects of an arterial thrombi?

A

Ischaemia
Infarction
Dependent on site and collateral circulation

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14
Q

What are some of the effects of a Venous thrombi?

A

Congestion
Oedema
Ischaemia (If the tissue pressure due to an oedema becomes higher than the arterial pressure)
Infarction

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15
Q

What are the outcome of thrombosis?

A 
Lysis
Propagation
Organisation
Recanalisation
Embolism
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16
Q

What happens in Lysis of a thrombus?

A

Complete dissolution, blood flow is reestablished

Most likely with small thrombi

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17
Q

What happens in Propagation of a thrombus?

A

There is progressive spread of thrombosis, distally in arteries and proximally in veins

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18
Q

What happens in organisation of a thrombus?

A

A reparative process with ingrowth of fibroblasts and capillaries
The lumen is still obstructed

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19
Q

What happens in recanalisation of a thrombus?

A

Incomplete blood flow is established through channels in the organising thrombus

20
Q

What happens in an Embolism of a thrombus?

A

Part of the thrombus breaks off and travels in the blood stream to lodge at a distant site.

21
Q

What is an embolism?

A

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

22
Q

What are some of the types of emboli?

A

Thrombo emboli
Air
Amniotic fluid
Nitrogen

23
Q

What organ is effected by thromboembolisms from systemic veins?

A

The lungs.

24
Q

How can thromboembolisms happen in the legs?

A

There is a thrombus in the Atheromatous Abdominal Aorta

25
Q

What are the 3 categories of Pulmonary Embolism?

A

Massive
Major
Minor
Recurrent

26
Q

What are the effects of a massive PE?

A

60% reduction in blood flow.

Rapidly fatal

27
Q

What are the effects of a major PE?

A

Medium sized vessel blocked.
Shortness of breath
Cough
Blood stained sputum

28
Q

What are the effects of a minor PE?

A

Small peripheral artery blocked

Asymptomatic or minor shortness of breath

29
Q

What are the effects of recurrent PEs?

A

Pulmonary hypertension

30
Q

What are the risk factors for deep vein thrombosis?

A 
Immobility
Post op
Pregnancy
Oral contraceptives
Severe burns
Cardiac failure
31
Q

What is the treatment for DVT?

A

Intravenous Herparin - fast acting anticoagulant as co factor for anti thrombin III
Oral Warfarin long term interferes with synthesis of vitamin K dependent clotting factors

32
Q

What are the signs of a fat embolism?

A

Rash
Shortness of breath
Confusion

33
Q

How can a cerebral embolism occur?

A

Atrial fibrillation can cause stasis and a thrombus in the left heart so passes to the brain.

34
Q

What is an Iatrogenic embolism?

A

One due to medial treatment eg air from an injection

35
Q

What is a Nitrogen embolism?

A

Nitrogen bubbles form in the blood with rapid decompression - the bends

36
Q

What is Disseminated Intravascular Coagulation?

A

A pathological actiation of coagulation mechanisms, occurs in response to some diseases. Small clots form in body and use all clotting factors so have abnormal bleeding.

37
Q

What can trigger Disseminated Intravascular Coagulation?

A

Infection
Trauma
Liver disease
Obstretric complication

38
Q

What type of disease is Haemophilia?

A

X linked recessive

39
Q

What factor is missing in type A Haemophilia?

A

Factor VIII

40
Q

What factor is missing in type B Haemophilia?

A

Factor IX

41
Q

What type of mutation causes Haemophilia?

A

A nonsense point mutation

42
Q

What are the effects of Haemophilia?

A 
Haemorrhage into major joints
Muscle bleeds
Necrosis of nerves
Haemorrhage into urinary tract
All cause pain
43
Q

How can Haemophilia be managed?

A

Self administered factor replacement therapy

44
Q

What is Thrombocytopenia?

A

The platelet count is way below the reference range

45
Q

What causes Thrombocytopenia?

A

Failure of platelet production
Increased platelet destruction
Sequestering of platelets

46
Q

What diseases usually accompany Thrombocytopenia?

A

Bone marrow dysfunctions

Mechanisms Of Disease (11 decks)

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