Thrombotic disorders Flashcards
What are the elements of haemostasis?
Primary- vasoconstriction, platelet adhesion and aggregation
Blood coagulation- insoluble fibrin formation and cross linking
Fibrinolysis
What are the 3 factors of Virchow’s triad?
Hypercoagulability of blood
Stasis of blood
Vessel wall injury
What can cause hyper coagulability?
Pregnancy
Cancer
Thrombophilia
Inflammatory disease
What can cause stasis of blood?
Immbolity
Varicose veins
Venous obstruction
What is an arterial thrombus?
White clot- platelets and fibrin
What does arterial thrombosis result in?
Ischaemia and infarction
What is arterial thrombosis often secondary to?
Atherosclerosis
What are the risk factors for arterial thrombosis?
Age Smoking Sedentary lifestyle Hypertension DM Obesity Hypercholesterolaemia
What is the management of arterial thrombosis?
Primary prevention- lifestyle modification, treatment of risk factors
Acute- thrombolysis, anti platelet/anticogulents
Secondary prevention
What is a venous clot?
Red clot- fibrin and red cells
What does venous thrombosis cause?
Back pressure
What is venous thrombosis principally due to?
Stasis and hypercoagulability
What are the risk factors for venous thrombosis?
Increasing age Pregnancy Hormonal therapy Tissue trauma Immobility Surgery Obesity Systemic disease FH Heritale thrombophilia
What systemic diseases are risk factors for venous thrombosis?
Cancer
Myoproliferayive syndrome
Autoimmune- IBD, connective tissue disease, antiphospholipid syndrome
How is venous thrombosis diagnosed>
Wells/Geneva score
D dimer
Imaging- Doppler US, CT pulmonary angio, V?Q scan
What is the management of venous thrombosis?
Anticoagulents- heparin, warfarin or direct acting oral anticoagulant
Thrombolysis in massive PE
What are microvascular clots?
Platelets and/or fibrin
What does microvascular thrombosis result in?
Diffuse ischaemia
When does microvascular thrombosis mainly occur?
In DIC
When does DIC primarily occur?
Septicaemia
Malignancy
Eclampsia
What does DIC cause?
Gangrene
Organ failure
What is DIC?
Diffuse systemic coagulation activation
Consumption of platelets and clotting factors leads to bleeding
