Thrombosis, Embolism & Shock Flashcards

1
Q

What is a thrombosis

A

It’s a clot:
Formation of a solid/semi solid mass from the constituents of the blood while moving within the vascular system during life

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2
Q

Where can a thrombi form?

A

Many places, such as:

  • Lumen of the heart
  • Arteries
  • Veins (DVT)
  • Capillaries
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3
Q

What 3 factors promote thrombosis?

A
  1. Abnormalities to the vessle wall
  2. Abnormalities of blood flow
  3. Abnormalities of the blood constituents
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4
Q

Give some possible abnormalities to vessel walls and which type of vessel they may form in…

A

ARTERIES- atheroma, inflammation
HEART- MI, rheumatic endocarditis (inflammatory heard disease with scar tissue from previous infarction causing autoimmune response)
VEINS- trauma, inflammation, chemicals (Sclerosants which get rid of varacous veins, glucose)
CAPILLARIES - Inflammation

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5
Q

What things can cause abnormalities of blood flow in the arteries?

A

Turbulance from:

  • Aneirysms
  • Plaques
  • Spasms
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6
Q

What sort of things can cause abnormalities of blood flow in the heart?

A
  • Atrial Fibrillation

- Aneurysms

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7
Q

What factors can cause abnormalities of blood flow in Veins?

A
Local Problems:
-Compression inactivity (from bed rest/ economy class syndrome)
General Problems
-Heart Failure
-Circulatory Shock
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8
Q

Having abnormality of blood constituents can promote thrombosis. Name some of the causes of blood abnormality constituents.

A

Increased thickness (Viscosity)

  • Polycythaemia
  • Dehidration
  • Chronic Hypoxia
  • Polychthaemia rubra vera (bone marrow disorder producing too many RBC)
  • Hyperproteinaemia
  • Multiple Myeloma (Tumour of plasma cells in bone marrow with accumulation of immunoglobulins in plasma)
  • Following Trauma (liver produces more clotting factoes)
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9
Q

Why are you more at risk of getting a thrombosis following a trauma?

(hint: blood constituents)

A

Because the liver produces more clotting factors so the blood if more viscous (thicker) making it at higher risk of clotting.

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10
Q

What is Thrombocythaemia?

A

It’s a rare disorder where the bone marrow overproduces platelets causing the blood to be thicker (viscous) and making the person more at risk of thrombosis

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11
Q

What is the definition of Embolism?

A

It’s the transport of abnormal material (solid, liquid, gas) by the blood stream and its impacting on a blood vessel.

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12
Q

Name some possible types of Emboli?

A
  • Pulmonay thromboembolus
  • Arterial Thromboembolism (can cause ischemia especially if in legs)
  • Fat embolism
  • Gas embolism (infusions, vascular surgery, caisson disease)
  • Tumour materia
  • Infective agents
  • Atheroma
  • Amniotic Fluid
  • Foreign bodies (IV drug abusers)
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13
Q

How does a tumour cause embolism?

A

Can happen when tumours penetrate blood vessels and parts may break away to form metastases.

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14
Q

How can pregnancy increase the risk of embolism?

A

The uterus may force amniotic fluid and squames from infant into uterine veins of mother.

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15
Q

What is the definition of the physiological state of SHOCK?

A

Shock is characterised by the significant, systemic reduction in blood beind delivered to capillaries (perfusion), resulting in decreased tissue oxygen delivery insufficient removal of cellular metabolic products, causing tissue injury.

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16
Q

Is shock the same as emotional shock?

A

NO

17
Q

What’s Hypovolaemic Shock?

A

It’s an emergency condition where there has been significant blood and fluid loss causing the heart to not be able to pump efficiently.

  • Severe burns
  • Haemorrhage
18
Q

What is Cardiogenic shock?

A

Cardiogenic shock is a state where the heart has been damaged to the point where it is unable to supply the body with enough blood and therefore nutrience. Causing organ failure.

  • Large MI
  • Other acute heart diseases
19
Q

What’s septic Shock?

A

When the body is infected with bacteria (endotoxins Gram -ve and exotoxins from gram +ve) and the vessles dilate so much that bp drops and is life-threatening.

20
Q

What is Anaphylactic shock?

A

It’s a sever form of allergic reaction from food, antibiotics and insect stings. dilates blood vessels and lowers BP. Life threatening

21
Q

What type of shock is associated with spinal cord trauma

A

Neurogenic Shock

Can be caused by damage to the CNS such as spinal cord injury. Characterised by low BP and slower HR.

22
Q

Cardiac tamponade (compression of heart by fluid in pericadial sac), tension pneumothorax and massive pulmonary embolism are causes to what type of shock?

A

Obstructive shock

23
Q

What are some clinical features of shock?

A
  • Low BP (less than 110)
  • Tachy (over 90bpm)
  • RR below 7/above 29
  • low urine output
  • metabolic acidosis
  • Hypoxia
  • cutaeous vasoconstriction/ vasodilation
  • anxiety, agitation, indifference, lethargy, obtunded