Thrombophilia Flashcards
What is an arterial thrombus?
high pressure system
platelet rich thrombus due to atherosclerotic plaque rupture exposing collagen
What is a venous thrombus?
low pressure system
activates the coagulation cascade (secondary Haemostasis) - rich in fibrin clot
What is Virchows Triad?
stasis
hypercoagulability
endothelial damage
What causes stasis?
age obesity pregnancy surgery paralysis
What causes hypercoagulability?
thrombophilia
malignancy
OCP
pregnancy
What causes endothelial damage?
deterioration of valves
previous DVT/PE
age
What is the lifetime risk of a VTE?
2.5%
What is thrombophilia?
abnormality of blood coagulation that increases your risk of clots
can be aquired or hereditary
caused by increased coagulation activity or decreased fibrinolytic activity
What are examples of hereditary thrombophilias?
factor V leiden prothrombin 20210 mutation antithrombin deficiency protein C deficiency protein S deficiency
How is hereditary thrombophilia treated?
avoid risks eg OCP
short term prophylaxis in periods of known risk
long term prophylaxis if recurrent thrombotic events
How many times does Factor V leiden increase VTE risk?
5
What is an example of an aquired thrombophilia?
antiphospholipid syndrome
What is antiphospholipid syndrome?
reccurent venous and arterial thrombosis
presenting as DVTs, PEs, miscarriage
What is the pathophysiology of antiphospholipid syndrome?
antibodies lead to a conformational change in B2 glycoprotein 1 which activates both primary and secondary haemostasis and vessel wall abnormalities
What are the investigations for antiphospholipid syndrome?
test for lupus anticoagulants and antibodies to B2-GP1-1
