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Haematology/immunology > Thrombic disorders > Flashcards

Thrombic disorders Flashcards

1
Q

What are the elements of haemostatsis?

A

Primary haemostasis
Blood coagulation
Fibrinolysis

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2
Q

What happens in primary haemostats?

A

Vasoconstriction
Platelet adhesion
Platelet aggregation

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3
Q

What happens in coagulation?

A

Insoluble fibrin formation

Fibrin cross-linking

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4
Q

What is a thrombus?

A

Clot arising in wrong place

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5
Q

What is a thromboembolism?

A

Movement of clot along a vessel

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6
Q

What is Virchow’s Triad?

A

Stasis
Hypercoagulability
Vessel damage

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7
Q

What can cause stasis?

A

Bed rest

Travel

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8
Q

What can cause hypercoagulabiity?

A

Pregnancy

Trauma

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9
Q

What can cause vessel damage?

A

Atherosclerosis

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10
Q

What are the types of thrombus?

A

Arterial
Venous
Microvascular

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11
Q

What is an arterial thrombosis made up from?

A

Platelets and fibrin

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12
Q

What does arterial thrombus result in?

A

Ischaemia and infarction

Usually secondary to atherosclerosis

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13
Q

What are examples of arterial thromboembolism?

A

Coronary thrombosis: MI/unstable angina
Cerebrovascular thromboembolism: stroke/transient ichaemia
Peripheral embolism: limb ischaemia

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14
Q

What are risk factors to arterial thrombosis?

A 
Age
Smoking
Sedentary lifestyle
Hypertension
DM
Obesity
Hypercholesterolaemia
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15
Q

What are the management options for arterial thrombosis?

A

Primary prevention: lifestyle modification and treatment of vascular risk factors

Acute presentation: thrombolysis, antiplatelet/anticoagulant drugs
Secondary prevention

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16
Q

What is venous thrombosis made up from?

A

Fibrin and red cells

17
Q

What does venous thrombus result in?

A

Back pressure

Principally due to stasis and hyper coagulability

18
Q

What are the main examples of VTE?

A

Limb DVT

PE

19
Q

What are risk factors for venous thrombosis?

A 
Increasing age
Pregnancy
Hormonal therapy: COCP/HRT
Tissue trauma
Immobility
Surgery
Obesity
Systemic disease
FHx
20
Q

What systemic diseases can cause venous thrombosis?

A

Cancer
Myeloproliferative neoplasm (MPNs)
Autoimmune disease: IBD, connective tissue disease (SLE), antiphospholipid syndrome

21
Q

How do you diagnose venous thrombosis?

A

Pretest probablility scores: Wells score/Geneve score
Lab testing if pretest probability low: D-dimer
Imaging

22
Q

What are the pretest probability scores for venous thrombosis?

A

Wells score

Geneva score

23
Q

What imaging techniques can you use to diagnosis venous thrombosis?

A

Doppler US
Ventilation/perfusion scan
CT pulmonary angiogram

24
Q

What is the aim of management in thrombosis?

A

Prevent clot extension
Prevent clot embolisation
Prevent clot recurrence in long term treatment

25
Q

What drugs can be used in thrombosis?

A

Anticoagulants: LMWH, coumarins (warfarin), DOACs

26
Q

When is thrombolysis used?

A

Selected cases e.g. massive PE

27
Q

What is heritable thrombophilia?

A

An inherited predisposition to venous thrombosis

28
Q

What are common heritable thrombophilias?

A

Factor V Leiden

Prothrombin G20210A

29
Q

What are rare heritable thrombophilias?

A

Antithrombin deficiency
Protein C deficiency
Protein S deficiency

30
Q

Who is screen for thrombophilia?

A

High risk heritable thrombophilia (antithrombin deficiency)

31
Q

What causes microvascular thrombus?

A

Platelets and/or fibrin

32
Q

What does microvascular thrombus result in?

A

Diffuse ischaemia

33
Q

When does microvascular thrombus usually happen?

A

In Disseminated Intravascular Coagulation (DIC)?

34
Q

What is DIC?

A

Diffuse systemic coagulation activation

Consumption of platelets and clotting factors leading to bleeding

35
Q

When does DIC occur?

A

Septicaemia
Malignancy
Eclampsia

36
Q

What does DIC cause?

A

Tissue ischaemia: gangrene, organ failure

Haematology/immunology (18 decks)

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