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Cardiology > thrombosis and embolism > Flashcards

thrombosis and embolism Flashcards

1
Q

atheroma symptoms

A

atherosclerosis
hardening of arteries
coronary artery disease
ischaemic heart disease

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2
Q

atheroma risk factor

A 
smoking 
hypertension 
hyperlipidemia 
diabetes
age 
males
genetics
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3
Q

atheroma pathogenesis

A 
primary endothelial injury
accumulation of lipds and macrophages 
migration of smooth muscle cells
increases in size with fibrous cap
rupture 
thrombosis
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4
Q

progression of atheromatous plaques

A

fatty streak
fibrofatty plaque
complicated plaque

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5
Q

complications of atheroma

A 
stenosis - cardiac ischaemia, cardiac fibrosis 
thrombosis
aneurysm 
dissection
embolism
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6
Q

deep vein thrombosis

A

a thrombosis formed in the deep venous circulation

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7
Q

pulmonary embolism

A

a thrombus that has embolised and lodged in the pulmonary circulation

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8
Q

venous thrombolitic disease

A

DVT and PE

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9
Q

Virchow’s triad

A

hypercoagulable state
endothelial injury
circulatory stasis

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10
Q

exposing risk factors for VTE

A 
surgery 
trauma 
acute medical illness
acute heart failure 
acute respiratory failure 
central venous catherisation
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11
Q

predisposing risk factors for VTE

A 
history of VTE
chronic heart failure 
age 
varicose veins 
obesity 
immobility or paresis
myeloproliferative disorders 
pregnancy/peripartum period
inherited or acquired thrombophilia 
hormone therapies 
renal insufficiency
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12
Q

exposing/predisposing risk factors for VTE

A

cancer

inflammatory diseases

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13
Q

risk factors VTE

A 
smoking 
travel
prothrombin gene mutation 
combined oral contraceptive 
hormone replacement 
Protien s or c deficiency 
factor V leiden mutation 
pregnancy 
active malignancy 
day surgery 
major surgery
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14
Q

DVT presentation

A

painful and swollen limb with redness and heat
tenderness along vein
sub-acute development

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15
Q

PE presentation

A

sudden SOB with pleuritic pain
possible collapse or haemoptysis
hypoxia and tachycardia
BP may be low

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16
Q

D dimer

A

is breakdown product of cross linked fibrin

17
Q

post thrombotic syndrome

A 
1/3 of patients within 5 years after idiopathic DVT
pain 
oedema 
hyperpigmentation 
eczema 
varicose collateral veins 
venous ulceration
18
Q

DVT management

A

oral anticoagulation

occasionally thrombolysis

19
Q

PE management

A

high risk - thrombolysis then oral coagulation

low or intermediate risk - oral coagulation

20
Q

anticoagulants

A

direct oral anticoagulant - apixaban or rivaroxaban
vitamin K antagonist - warfarin
low molecular weight heparin injections

21
Q

stroke

A

acute onset of neurological symptoms and sign due to disruption of blood supply

22
Q

haemorrhagic stroke

A

15-20%
raised BP
weakened blood wall due to structural abnormalities or inflammation

23
Q

ischaemic stroke

A

80-85%
thrombolytic
embolic
hypoperfusion - due to stenosed artery

24
Q

non modifiable risk factors for stroke

A 
age 
family history
gender 
race 
previous stroke
25
Q

potentially modifiable risk factors for stroke

A 
hypertension 
hyperlipidemia 
smoking 
prior history of transient ischaemic attack 
atrial fibrillation 
diabetes 
congestive heart failure 
alcohol excess
obesity 
physical inactivity 
poor socioeconomic status
26
Q

stroke management

A

thrombolysis and thrombectomy
treat cause
multidisciplinary assessment and rehabilitation

27
Q

stroke mimics

A 
hypoglycaemia 
hyponatremia 
seizure 
migraine 
brain tumour
functional hemiparesis
28
Q

atheroembolism

A

from a thrombus forming on an atherosclerotic plaque infarcts in same side as affected carotid artery
platelet rich

29
Q

cardioembolism

A

from clot formed in the heart infarcts in more than one arterial territory, bilateral
clotting factor rich

30
Q

ischaemic stroke investigations

A

blood tests - glucose, lipids, thrombophilia screen

assess for hypertension

31
Q

haemorrhagic stroke investigations

A

imaging to investigate cause
hypertensive
underlying aneurysm
vasculitis

32
Q

surgical management for stroke

A

haematoma evacuation
relief of raised intracranial pressure
carotid endartectomy

33
Q

transient ischaemic attacks

A

temporary neurological symptoms due to occlusion of artery stopping flow of blood

Cardiology (14 decks)

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