THROMBOTIC DISORDERS Flashcards
Thrombosis
Thrombophilia is a predisposing
risk factor to __________
venous
thromboembolism
Thrombophilia
➢Defined as _______ determined ____eased likelihood of
thrombosis in an individual
genetically
incr
Thrombosis
Thrombophilia
➢Specific thrombophilic risk
factors can be determined in
approx _____% of pts with venous
thromboembolism
70
Thrombophilia
a) Common forms include
•__________ (________)
•Prothrombin G20210A (____________)
•Increased _____ levels
b) Rare forms
•________ deficiency
•________ deficiency
•___________ deficiency
c) Very rare forms
•________________
•Homozygous _________
Factor 5 Leiden; activated protein C
resistance
Increased plasma prothrombin; VIII
Protein C ; Protein S; Antithrombin
Dysfibrinogenaemia; homocystinuria
Diagnosis of DVT
•Clinical history (including family) and
examination
•________________, if normal repeat in _______ latter
•_________
•Plasma _________
•_______ profile
•Chest USS, spiral CT, pulm angio –
•Tests for thrombophilias
Doppler ultrasonography; 7 days
Venography
D – dimer
Clotting
Venous thromboembolism
➢A (common or rare?) thrombotic disorder
➢Annual incidence approx 1 /
______
Common
1000
Venous thromboembolism
➢Incidence ______eases with age
➢Most pulmonary emboli arise
from (proximal or distal?) ______ ( popliteal, femoral, iliac veins)
incr
Proximal
DVT
Treatment
Objectives of treatment include:
1. Prevent death from ___________
- Prevent morbidity from __________ or _________
- Prevent or minimize ___________
pulmonary embolism
venous thromboembolism or pulmonary embolism
post -thrombotic syndrome
Anticoagulant therapy
1. Standard ______ (UFH)
2.___________ —————-
3.________ anticoagulants (CI in pregnancy)
- therapy in patients with ________ and ________ with associated _______ or ______
- _______________ in patients with acute DVT and an absolute contraindication for anticoagulation
- ___________
heparin
Low molecular weight heparin
Oral; MI & pulm embolism
hypotension or syncope
Inferior vena cava filter
Thrombectomy
treatment
New oral Anticoagulants:
I) ________
II)____________
Dabigatran
Rivaroxaban
Dabigatran- a potent ________
Rivaroxaban- a —————
Oral thrombin inhibitor
Factor Xa inhibitor
Fibrinolysis
✓Plays important role in _________
✓Maintenance of ——- vascular
system
✓Proenzyme -________
✓Converted to ________
dissolution of blood clots
patent
PLASMINOGEN
PLASMIN
Fibrinolysis
✓Plasmin degrades ____ into ______
fibrin; soluble
FDPs
Fibrinolysis
_____,_______ (potent, distinct physiologic
activators of plasminogen)
tPA, uPA
streptokinase is an enzyme
T/F
F
Not an enzyme
