Thrombotic disorders Flashcards

1
Q

What is primary haemostasis?

A

Initial plug from platelets

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2
Q

What is thromboembolism?

A

Movement of thrombus through a blood vessel

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3
Q

What is virchow’s triad?

A

3 factors that lead to thrombosis:
Stasis
Hypercoagulability
Vessel damage

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4
Q

What can cause stasis?

A

Bed rest

Travel

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5
Q

What can cause hypercoagulability?

A

Pregnancy

Trauma

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6
Q

What can cause vessel damage?

A

Atherosclerosis

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7
Q

What are the biggest component of arterial thrombus?

A

Platelets over fibrin

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8
Q

What happens as a result of arterial thrombus?

A

Ischaemia and infarction typically secondary to atheroma

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9
Q

What is caused by coronary thrombosis?

A

MI

Unstable angina

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10
Q

What is caused by cerebrovascular thromboembolism?

A

Stroke

TIA

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11
Q

What is caused by peripheral embolism?

A

Limb ischaemia

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12
Q

What are risk factors for arterial thrombosis?

A
Age
Smoking
Sedentary lifestyle
Hypertension
Diabetes mellitus
Obesity
Hypercholesterolaemia
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13
Q

How is arterial thrombosus managed?

A

Primary prevention - lifestyle modification, treatment of vascular risk factors
Acute presentation - thrombolysis, antiplatelet/anticoagulant drugs
Secondary prevention

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14
Q

What is a venous thrombus composed of?

A

Fibrin and red cells

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15
Q

What are other names for atherial thrombus and venous thrombus?

A

White clot - arterial

Red clot - venous

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16
Q

What is the main cause of venous thrombus?

A

Stasis and hypercoagulability

17
Q

What are common venous thrombosis problems?

A
Limb DVT
Pulmonary embolism
Visceral venous thrombosis
Intracranial venous thrombosis
Superficial thrombophlebitis/thrombosis
18
Q

Why does cervical rib cause risk of upper limb DVT?

A

Rib presses on the subclavian vein

19
Q

What are risk factors for venous thrombosis?

A
Increasing age
Pregnancy
Hormonal therapy
Tissue trauma
Immobility
Surgery
Obesity
Systemic disease
Family history
20
Q

What systemic diseases are associated with venous disease?

A
Cancer
Myeloproliferative neoplasm
IBD
Connective tissue disease ie lupus
Antiphospholipid syndrome
21
Q

How is venous thrombosis diagnosed?

A

Pretest probability scoring - Wells score, Geneva score
D-dimer is pretest probability low
Imaging

22
Q

What is the aim of venous thrombosis management?

A

Prevent clot extension
Prevent clot embolisation
Prevent clot recurrence in long term treatment

23
Q

What are the most common modalities for imaging of venous thrombosis?

A

Doppler ultrasonography for DVT - if vein isn’t compressible indicative of clot
V/Q scan
CXR
CT pulmonary angiogram - gold standard for PE

24
Q

What drugs are used to treat venous thrombosis?

A

Anticoagulant - Low molecular weight heparin, coumarins (warfarin), Direct oral anticoagulants
Thrombolysis only in selected cases - massive PE

25
How long do you anticoagulate patients for in venous thrombosis?
Minimum of 3 months, after 3 months decide if it's long term
26
Who is treated long term for venous thrombosis?
People with associated ongoing risk factors
27
What is heritable thrombophilia?
Inherited predisposition to venous thrombosis
28
What is the most common mutation causing heritable thrombophilia?
Factor V Leiden
29
What are components of microvascular thrombus?
Platelets and/or fibrin
30
What happens as a result of microvascular thrombosis?
Diffuse ischaemia
31
What is the commonest cause of microvascular thrombosis?
Disseminated intravascular coagulation
32
Where does disseminated intravascular coagulation occur?
Septicaemia Malignancy Eclampsia