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Haematology and immunology > Thrombotic disorders > Flashcards

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
Q

How long do you anticoagulate patients for in venous thrombosis?

A

Minimum of 3 months, after 3 months decide if it’s long term

26
Q

Who is treated long term for venous thrombosis?

A

People with associated ongoing risk factors

27
Q

What is heritable thrombophilia?

A

Inherited predisposition to venous thrombosis

28
Q

What is the most common mutation causing heritable thrombophilia?

A

Factor V Leiden

29
Q

What are components of microvascular thrombus?

A

Platelets and/or fibrin

30
Q

What happens as a result of microvascular thrombosis?

A

Diffuse ischaemia

31
Q

What is the commonest cause of microvascular thrombosis?

A

Disseminated intravascular coagulation

32
Q

Where does disseminated intravascular coagulation occur?

A

Septicaemia
Malignancy
Eclampsia

Haematology and immunology (19 decks)

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