Thrombosis Flashcards
virchows triad
- endothelial injury
- blood stasis / turbulent blood flow
- hypercoagulability
what are that anti platelet effects of the endothelium?
- non activated platelets do not adhere
2. PGI2 and NO prevent platelet adhesion
what are the anticoagulant properties of the endothelium?
- heparin like molecule activates antithrombin III
2. thrombomodulin binds thrombin which activates protein C
what are the fibrinolytic properties of the endothelium?
synthesis of TPA
what are the prothrombotic properties of the endothelium?
- vWF
- tissue factor
- plasminogen activating factor
what are the four fates of a thrombus?
- propagation (progression)
- embolization
- lysis
- organization and recanalization
what is the most common cause of preventable hospital death?
PE
what is an important consideration for factor V Leiden disease?
gene dose
what is the effect of oral contraceptives on factor V Leiden disease?
highly increased
what are the common inherited thrombophilias?
- antithrombin deficiency
- protein C deficiency
- protein S deficiency
- factor V Leiden
what are the features of antithrombin III deficiency?
- autosomal dominant
- thrombotic phenomena in adolescence
- PE is usually first sign
what are the features of protein C deficiency?
- autosomal dominant and recessive
2. skin necrosis when warfarin is introduced
what are the features of protein S deficiency?
- autosomal dominant
- skin necrosis when warfarin is introduced
- usually presents as an infant
pathogenesis of factor V Leiden
- protein C mutation
2. slows inactivation of factor Va by protein C
what are the therapeutic options for thrombocytopenia?
- unfractionated heparin
- LMW heparin
- coumadin
- aspirin
- Gp IIb / IIIa inhibitors
