Thrombosis, Embolism and Atherosclerosis Flashcards
What can cause endothelial injury?
Hyperlipidaemia Hypertension Smoking Toxins Vasculitis viruses Immune reactions
Why do changes in blood flow lead to the thrombosis?
Platelets come into contact with endothelium
Activated clotting factors are not diluted by normal rapid blood flow
Inflow of anticoagulant factors is slowed
Activation of endothelial cells is promoted
Examples of high risk Hypercoaguable states?
MI Immobilisation Tissue damage Cancer Prosthetic heart valves
Low risk hypercoaguable states
AF Cardiomyopathy Oral contraceptive pill Late pregnancy Sickle cell anaemia Smoking
What genetic mutations cause a hypercoaguable state?
Factor V mutations
Defects in anticoagulant pathway
Defects in fibrinolysis
What colour are arterial thrombi?
White
What colour are venous thrombi?
Red
Presentation of pulmonary thromboembolism?
Wedge shaped and firm
Dyspnoea
Chest pain
Haemoptysis
Who can gas/air embolisms occur in?
Divers
Risk factors for atherosclerosis
Age Sex "Genetics" Hypertension Smoking diabetes Hyperlipidaemia Lack of exercise Oestrogen if status (post-menopausal, the pill) Stress
Stages of atherosclerosis
Endothelial dysfunction Macrophage activation Lipoprotein oxidation Foam cell formation, fatty streak Plaque formation and growth
What is Virchow’s triad?
Endothelial injury
Hypercoagulability
Changes in blood flow
