Thrombosis and Embolism Flashcards
What is the classic presentation of a hypercoaguable state?
Recurrent DVT or DVT at an early age
can be hepatic or cerebral veins–low flow
What are the functions of proteins C and S?
They inactivate factors V and VII
Risk of Warfarin skin necrosis is increased by?
Protein C and S deficiency. Warfarin therapy reduces C and S first (shorter half life) causing a severe hypoercoaguable state in light of previous deficiency. Of course long term wafarin is a anti coagulant.
What is the most common inherited hypercoaguable state?
Factor V Leiden. The mutated factor V lacks cleavage site for proteins C and S. Decreased negative feedback.
what does prothrombin 20210A cause?
the mutation increases expression of prothrombin,
What reduces the effect of heparin like molecules?
AT III (antithrombin) deficiency
What hormone increases production of coagulatin factors?
estrogen, especially with use of oral contraceptives
What is the difference between an embolism and a thromboembolism?
an embolism is an intravascular mass that occludes vessels. A thromboembolism is die to a dislodged thrombus
What embolism is from a dislodged plaque?
atherosclerotic embolism
What causes petechiae over the chest, dyspnea and is associated with fractures?
Fat embolism
What embolism presents with DIC and SOB?
amniotic fluid embolism
What is the most common source of PE and what veins are involved?
DVT
femoral
popliteal
iliac
What is the classic cause of a wedge shaped infarct?
PE
What is a saddle embolus?
a PE that blocks both left and right pulmonary arteries.
What is a cause of pulmonary hypertension?
chronic silent emboli that organize with time. Dual blood supply causes many to at first be silent.
