Thrombotic Disease

Question 1

Is this the blood being too thin or too thick?

Answer 1

Thick

Question 2

What is the definition of a Thrombus?

Answer 2

Clot arising in the wrong place

Question 3

What is the definition of a thromboembolism?

Answer 3

A clot moving along the vessel and lodging elsewhere

Question 4

What is the traid that results in a clot formation?

Answer 4

Virchow’s triad:
Hypercoaguablility
Stasis
Vessel damage

Question 5

Give 2 examples of stasis

Answer 5

Bed rest and travel

Question 6

Give 2 examples of a hypercoaguable state

Answer 6

Pregnancy and trauma

Question 7

Give 2 examples of vessel damage

Answer 7

Athersclerosis and limb ischaemia

Question 8

What are the 3 main types of thrombosis?

Answer 8

Arterial
Venous and
Microvascular

Question 9

What type of clot is an arterial clot? What dies it result in?

Answer 9

This is white clot of fibrin + platelets and causes ischaemia ad infarction

Question 10

What type of clot is a venous clot? What dies it result in?

Answer 10

Red clot od fibrin and RBC’s, this will result in back up pressure

Question 11

What type of clot is a microvascular one and what does it cause?

Answer 11

This is platelets and fibrin and causes diffuse ischaemia

Question 12

What is an arterial clot mainly due to?

Answer 12

Atherosclerosis

Question 13

What is a venous clot mainly due to?

Answer 13

Hypercoaguability

Question 14

What is the main course of microvascular clots?

Answer 14

Disseminated Intravascular Coagulation

Question 15

Give 3 examples of each do the 3 types of thrombosis

Answer 15

A= MI, Cerebrovascular thromboembolism ie Stroke and TIA, or peripheral embolism ie ischamia 
V = DVT, PE and visceral venous thrombosis 
MC = DIC due to septicaemia, malignancy, eclapsia or gangrene

Question 16

What are the risk factors for an arterial thrombus?

Answer 16

Age 
Smoker
Sedentary lifestyle
HT
Dm
Obesity and hypercholesteraemia

Question 17

What are the risk factors for a venous thrombus?

Answer 17

Increasing age, PE. hormonal therapy ie COCP and HRT
Immobility
Obesity 
Cancer
Autoimmune eg IBD/SLE
Tissue trauma

Question 18

What is a common risk factor for both A and V thromboembolisms?

Answer 18

Antiphospholipid syndrome

Question 19

What are the 2 main tests for an arterial thrombus?

Answer 19

ECG

ECHO(if suspect MI)

Question 20

What scoring system are you going to use for VTE?

Answer 20

WELL’s/ GENEVA score

Question 21

What are the primary investigation for a VTE?

Answer 21

D-dimer and imaging ie CTPA for PE
Doppler US(DVT), VQ scan
FBC and ECG

Question 22

What are the clinical signs of a DVT

Answer 22

Hot, red, swollen calf

Milf fever and pitting oedema

Question 23

What are the features of a PE?

Answer 23

Acute SOB
Pleuritic chest pain 
Tachypnoea
Tachycardia
Hypotensive
Cyanosis 
Pleural rub/effusion 
Inc JVP

Question 24

what is the primary prevention os a arterial TE?

Answer 24

reduce weight, treat the vascular risk, down spoke, ensure fo hypercoaguable/atherosclorotic state - medications

Question 25

How are you going to age the acute ATE?

Answer 25

Thrombolysis and anti platelet/ anticoagulant therapy ie :MWH and aspirin
Rivaroxiban

Question 26

How are you going to treat the acute VTE?

Answer 26

Anticoagulants:
LMWH
Warfarin 
DOACs
Thrombolysis but only in massive PE

Question 27

Name the key heritable thrombophilia?

Answer 27

Factor V Leiden Mutation

Question 28

Hoe does F5L cause increased risk of DVT?

Answer 28

Factor V Leiden: promotes Va so more Xa can convert thrombin to prothrombin

Question 29

What are 3 rare thrombophilia

Answer 29

Antithrombin deficiency
Protein S deficiency: More VIIa and Va
Protein C deficiency