Thromboembolism and shock Flashcards
(clot in original position):
Precedent of everything formation of inappropriate blood clot
Thrombosis
(clot in circulation): Can obstruct a
vessel where it will lodge can cause ischemia
to the surrounding tissue being supplied by
that vessel leading to infarction
Embolism
Circulatory failure part of
hemodynamic disorder with unique
characteristics but sometimes overlaps with
symptoms of thromboembolic disease
Shock
is one of the scourges of modern
man, because it underlies the most serious and
common forms of cardiovascular disease.
Thrombosis
If there is embolism in the lungs particularly in the
pulmonary vein, there will be________
pulmonary infarction.
Virchow’s triad: Endothelial Injury can cause ____
abnormal
blood flow and hypercoagulability
Virchow’s triad: Abnormal Blood Flow can lead to or
cause _____
endothelial injury and
hypercoagulability
T or F
Hypercoagulability does NOT cause
either endothelial injury or abnormal
blood flow
T
Injury to the endothelium leads to ______ (inhibited by aspirin)
Platelet activation
When there is endothelial injury, it exposes the
endothelium to _________ which leads to platelet activation.
Von Willebrand factor and tissue
factor
Causes of Endothelial injury
o Physical Injury o Infection o Abnormal Blood Flow o Inflammatory mediators o Metabolic Abnormalities o Toxins from cigarette smoke
This triggers Endothelial activation or dysfunction
that shifts the pattern of gene expression in
endothelium to _______
prothrombotic.
The 2 Prothrombotic Alterations
o Procoagulant changes
o Antifibrinolytic effects
In procoagulant changes, there is downregulation of thrombomodulin, as well as _________ and _____
Protein C and TFPI
In antifibrinolytic effects, Activated endothelial cells
secretes _________which
downregulates t-PA and limits
fibrinolysis
plasminogen activator
inhibitors (PAIs)
normal flow of blood in the
vessels is known as
laminar flow
T or F
Laminar flow
allows the red cells to travel centrally in the blood
vessels and plasma in the outer portion to prevent
the red cells from having contact with the
endothelium.
T
Blood flow can be altered in 2 ways:
Turbulence
Stasis
▪ Contributes to arterial and
cardiac thrombosis by causing endothelial injury
▪ Also forming little pockets of countercurrents that contribute to stasis
Turbulence
▪ Allows development of venous thrombi
Stasis
-Refers to an abnormally high tendency of the
blood to clot, typically caused by alterations in
coagulation factors
- important in venous thrombosis
HYPERCOAGULABILITY
▪ also called Leiden mutation
▪ Arg to Gln substitution in amino acid residue 506
▪ 60% in patients with recurrent DVT
Factor V mutation (autosomal dominant) (2-15%)
In factor V mutation, Heterozygotes have a ____ increased relative
risk of venous thrombosis, and homozygotes
have a ____increase
fivefold; 50-fold