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CVS > Thrombosis 2 > Flashcards

Thrombosis 2 Flashcards

1
Q

What factors favour thrombosis? (virchows triad)

A
  1. Endothelial injury
  2. Abnormal blood flow- Stasis
  3. Hyper-coagulation of blood
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2
Q

What is thrombosis?

A

Formation of blood clot in a blood vessel, restricting blood flow

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3
Q

How do platelets become activated in thrombosis?

A

Endothelial damage exposes collagen to the outer surface. Collagen binds to Glycoprotein Ia/IIb on platelets. Increase in platelet integrins. Glycoprotein Ia/IIb binds to fibrinogen: brings platelets together. Activated platelets release granules to attract other platelets: thromboxaneA2(TXA2), Platelet activating factor (PAF), ADP.

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4
Q

What substance formation marks the endpoint of coagulation?

A

Fibrin- Brings platelets together in a fine mesh to form a solid stable blood clot.

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5
Q

What are some common coagulation factors involved in a typical cascade?

A

Factor IIa- Thrombin Factor V, X Factor II, XIII- Activate fibrinogen. Thrombin- converts fibrinogen to fibrin.

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6
Q

Why is Vitamin K important?

How can liver disease affect it?

What drug inhibits Vitamin K?

A

Needed to make coagulation factor II, VI, IX, X.

Liver disease- No vitamin K produced as it is ususally stored in liver. hence no factors produced

Warfarin- Inhibits vitamin K from producing factors

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7
Q

What disease can be commonly associated with thrombosis?

A

Hypertension. High pressure blood flow can cause damage to the endothelium more easily.

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8
Q

Why is arterial thrombosis uncommon?

A

Blood stasis uncommon

Arterial blood flow is high (diff to pressure) so pro-coagulation materials are moved along before they can bind to the endothelium to do anything.

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9
Q

What is atherosclerosis and when can thrombosis occur in relation to it?

A

Formation of plaques on the surface of the endothelium, most commonly due to hypertension. Turbulent flow= increased endothelial damage

Plaque rupture= thrombosis formation

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10
Q

What are some common diseases where thrombosis/emboli to occur?

A
  1. Cerebral infarction
  2. Carotid atheroma
  3. Myocardium infarction
  4. Aortic aneurysm
  5. DVT/ peripheral vascular disease
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11
Q

What is the difference between stable/ unstable angina?

A

Stable- exercise induced Unstable- Plaque ruptures, causing thrombosis

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12
Q

What is Poiseuille’s law?

A

Small narrowing in a blood vessel can greatly affect the decreased blood flow to the tissues.

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13
Q

What can be some other causes of endothelial injury?

A
  • Toxins - Smoking - Infectious agents
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14
Q

What is an autoimmune disease causing endothelial injury?

A

Primary vasculitis- Autoimmune disease characterised by inflammation of the vessel walls.

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15
Q

What are the effects of Turbulence?

A
  1. Endothelial damage
  2. Stasis
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16
Q

What is stasis? What are its effects?

A

Blood flow usually smooth and laminar. In stasis, blood flow slows down. Effect- Increased platelet contact with endothelial wall

17
Q

Where does stasis occur? why?

A

Veins. Due to:

  1. Valves not functioning
  2. Venous insufficiency (insufficient flow of blood through veins causing pooling of in the legs).
18
Q

What is the role of plasmin?

A

Breaks clots

19
Q

What are some Anti-clotting proteins?

A
  1. Protein C,
  2. Protein S
  3. Anti-thrombin III
20
Q

What is factor V Lieden hyper-coagulability?

A

-Mutation in Point of factor V - Protein C, S, anti thrombin III deficiency

21
Q

What are some secondary causes of hyper-coagulability?

A
  • prolonged immobility -Cancer -MI,AF Low risk: the pill, smoking, renal disease, cardiomyopathy
22
Q

What is an embolism?

A

Dislodged thrombus. Travels around vascular system until it gets stuck

23
Q

What is the difference between ischaemia and infarction?

A

Ischaemia- insufficient blood supply Infarction- tissue death due to ischaemia

24
Q

Which common branching vessels often get thrombus?

A
  • Coronary arteries - above bifurcation of aorta - origin and division of carotid arteries - renal artery - superior mesenteric artery

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