Thrombosis

Question 1

Thrombosis definition

Answer 1

Intravascular clot in living person

Question 2

Thrombi definition

Answer 2

Solid or semi solid mass from constituents of blood in vascular system

Question 3

Components of thrombi

Answer 3

Platelets
Fibrin
RBC
WBC

Question 4

Virchows triad - predisposition to thrombosis

Answer 4

Alteration in vessel wall
Alteration of normal blood flow ( slow or turbulent)
Alteration of blood constituents

Question 5

Endothelial cell injury causes

Answer 5

Rheumatic fever

Vegetation on valve cusps

Healed myocardial infarction causing mural thrombus

Atheromatous plaques

Vasculitis

Radiation injury

Chemical agents

Toxins

Question 6

Endothelial cell pathogenesis

Answer 6

Underlying basement membrane exposed

Platelets can bind through factor VII

Platelets aggregates joins

Release of procoagulant substances ( thromboplastin, platelet activating factor)

Reduction in anticoagulant substances ( thrombomodullin, antithrombin III, NO, plasminogen activato)

Thrombi formed

Question 7

Altered blood flow pathogenesis

Answer 7

Platelets comes in contact with endothelium

Decreased dilution of activated clotting factors by fresh flowing blood

Decreased flow of anticoagulants

Question 8

Types of hypercoagubility

Answer 8

Primary - genetic defect of coagulation proteins

Secondary - clinical conditions associated with recurrent thrombosis

Question 9

Primary causes of hypercoagubility

Answer 9

Antithrombin III déficiency

Fibrinolysis defect

Protein C and S deficiencies ( anticoagulants)

Factor V mutant

Mutant prothrombin gene

Methyltetrahudrate mutation gene

Question 10

High risk secondary hypercoagubility conditions

Answer 10

Prolonged bed rest 
Myocardial infarction 
Tissue damage 
Cardiac failure 
Cancer
Acute leukaemia 
Prosthetic cardiac valve 
DIC

Question 11

Low risk secondary hypercoagubility

Answer 11

Atrial fibrillation
Cardiomyopathy
Nephrotic syndrome 
late pregnancy
Birth control 
Smoking
Hyperlipidaemia
Sickle cell disease 
thrombocytosis

Question 12

How do you differentiate alive from postmortem clots

Answer 12

Line of zhan present in thrombosis

Question 13

Pale white thrombus

Answer 13

Rapidly flowing blood
Mostly in arteries
Few RBC trapped

Question 14

Red thrombus

Answer 14

Slow flowing blood / stagnant
A lot of TBC trapped
Mostly veins

Question 15

Parieral thrombus

Answer 15

Merely restrict lumen

Question 16

Occlusive thrombus

Answer 16

Fills lumen

Question 17

Arterial thrombus mural or occlusive ?

Answer 17

arterial generally occlusive except in large arteries where mural

Question 18

Phlebothrombosis mural or occlusive?

Answer 18

Almost always occlusive

Question 19

Possible fate of thrombus

Answer 19

• can be removed by enzymes
• can be organized
• can propagate
• can be recanalized to allow patent vessel again
• can embolize