thrombotic disorders Flashcards
what are the different elements of Haemostasis ?
primary haemostasis - vasoconstriction, platelet adhesion, platelet aggregation
blood coagulation - cross-linking
fibrinolysis - done by plasmin
what is Virchow’s triad ?
stasis - bed rest, travel
vessel damage - atherosclerosis
hypercoagulabolity - pregnancy, trauma
what are features of arterial thrombus ?
white clot - platelets and fibrin
results in ischaemia and infarction
secondary to atherosclerosis
what are examples of arterial thromboembolism ?
coronary thrombosis
cerebrovascular thromboembolism
peripheral embolism
what are risk factors for arterial thrombosis ?
age smoking sedentary lifestyle hypertension DM obesity hypercholesterolaemia
how do you manage arterial thrombosis ?
primary prevention
thrombolysis
anti platelet/anti coagulant
what are features of a venous thrombus ?
red thrombus - fibrin and red cells
results I back pressure
due to stasis and hyper coagulability
what are examples of venous thromboembolism ?
limb DVT
pulmonary embolism
what are risk factors for venous thrombus ?
age pregnancy hormonal therapy - COCP, HRT tissue trauma immobility surgery obesity systemic disease FHx
what systemic diseases cause venous thrombus ?
cancer
myeloproliferative neoplasms
autoimmune disease - IBD, SLE, antiphospholipid
how do you diagnose venous thrombosis ?
probability score - Well's score, Geneva score lab test - D-dimer imaging doppler USS V/Q scan CTPA
how do you treat venous thrombosis ?
LMWH
warfarin
DOACs - apixiban
thrombolysis in massive PE
what are the heritable thrombophilia diseases ?
common - Factor V Leiden, prothrombin G20210A
rare - antithrombin deficiency, protein C deficiency, protein S deficiency
how does factor V Leiden work ?
the mutated factor V cannot be bound to by protein C and so this leads to a hyper coagulable state
