Thrombotic Disorders

Question 1

What kind of clot is found in the arterial vs venous system?

Answer 1

Arterial = White clots (platelets & fibrin)

Venous = Red Clots (Fibrin & Red cells)

Question 2

What causes venous vs arterial thrombi?

Answer 2

Arterial - Secondary to Atherosclerosis

Venous - Secondary to Stasis & Hypercoagulability

Question 3

Risk factors for an arterial thrombosis?

Answer 3

• Age
• Smoking
• Sedentary
• HTN
• DM
• Obesity
• Hypercholesterolaemia

Question 4

How do we manage an arterial thrombus?

Answer 4

Primary prevention with lifestyle modification and treating the risk factors

Acutely: thrombolysis & Anti-platelets or Anti-coags

Secondary prevention

Question 5

Risk factors for a DVT or PE?

Answer 5

Age
Surgery
Tissue Trauma
Immobility
Obesity
Pregnancy
Hormonal Therapy
FH
Systemis disease

Question 6

What systemic diseases put you at risk of a DVT?

Answer 6

Cancers
Myeloproliferative Neoplasm
Autoimmune e.g. IBD, SLE or Anti-phospholipid syndrome

Question 7

How can we test for a DVT/PE?

Answer 7

Pretest probability scoring (Well’s or Geneva scores)
If probability score is low do a D-dimer

Doppler US

V/Q scan & CT Pulm Angiogram

Question 8

How can we treat a DVT/PE?

Answer 8

Anticoagulants e.g. LMWH, Warfarin & DOACs

Thrombolysis only if massive PE

Question 9

What are the commonest Heritable Thrombophilias?

Answer 9

Factor V Leiden

Prothrombin G20210A

Question 10

What’s the major cause of microvascular Thrombus?

Answer 10

Disseminated Intravascular Coagulation (DIC)

Question 11

What makes up microvascular thrombi?

Answer 11

Platelets &/or fibrin

Question 12

What triggers DIC?

Answer 12

Septicaemia
Malignancy
Eclampsia

Question 13

What are the consequences of DIC?

Answer 13

Diffuse Tissue ischaemia –> Gangrene & Organ Failure

Consumes platelets/clotting factors –> Bleeding