Thrombotic Disorders Flashcards
What is involved in coagulation?
Insoluble Fibrin formation
Fibrin cross linking
Outline the process of fibrinolysis?
Urokinase and t-PA with factor XII
Converts Plasminogen to Plasmin
Breaks Fibrin into fibrinogen/fibrin degradation products
What is a thrombus?
Clot in wrong place
What is a thromboembolism?
Movement of a clot along a vessel
What is Virchows Triad?
Hypercoaguability
Stasis
Endothelial disruption
What are the causes of a hypercoaguable state?
Pregnancy
Trauma
How do Arterial Thrombus appear?
‘white clots’ - platelets and fibrin
Ischaemia and infarct
Secondary to atherosclerosis
What are the risk factors for arterial thrombosis?
Age Smoking Sedentary lifestyle Hypertension Diabetes mellitus Obesity Hypercholesterolaemia
How is arterial thrombosis managed?
Primary prevention
Thrombolysis
Antiplatelet/anticoagulants
How do Venous Thrombus appear?
‘Red thrombus’ fibrin and RBC
Back pressure
Stasis and hypercoaguability
What are the risk factors for venous thrombosis?
(Stasis/hypercoaguability) Age Surgery/Tissue trauma Obesity Pregnancy Hormonal therapy Systemic disease
What systemic diseases are associated with venous thrombosis?
Cancer
Myeloproliferative neoplasms
Autoimmune disease (IBD, Lupus)
How is Venous thrombosis diagnosed?
Wells/Geneva score D-dimer if score low Imaging: - Doppler USS - V/Q scan - CTPA
What drugs are used in venous thromboembolism?
Anticoagulants: - LMW Heparin - Warfarin - DOACs Thrombolysis in massive PE
What are the main heritable thrombophilias?
Factor V Leiden
Prothrombin G20210A
How does Microvascular thrombus present?
Platelets and/or fibrin
Diffuse ischaemia
Disseminated Intravascular coagulation (DIC)
What is Disseminated Intravascular coagulation (DIC)?
Systemic coagulation activation associated with other diseases
How does Microvascular thrombus present?
Platelets and/or fibrin
Diffuse ischaemia
Disseminated Intravascular coagulation (DIC)
What causes Disseminated Intravascular coagulation (DIC)?
Septicaemia
Malignancy
Eclampsia
Disseminated Intravascular coagulation (DIC) leads to what?
Microvascular ischaemia
Gangrene
Organ failure
