Thrombotic Disorders

Question 1

Virchow’s triad of thrombosis

Answer 1

stasis, vessel damage and hypercoagulability

Question 2

arterial thrombus is white/red and what is it made up of

Answer 2

white clot made of platelets and fibrin

Question 3

give 3 examples of arterial thrombuses

Answer 3

MI, unstable angina and ischaemic stroke

Question 4

give 5 risk factors for arterial thrombus

Answer 4

smoking, obesity, hypertension, diabetes and hypercholoesterolaemia

Question 5

which one of virchow’s triad causes an arterial thrombus

Answer 5

vessel damage

Question 6

what is meant by vessel damage

Answer 6

a vessel that isn’t perfect - like atherosclerosis

Question 7

venous thrombus is white/red and what is it made up of

Answer 7

red thrombus made up of fibrin and red cells

Question 8

elements of virchow’s triad which cause venous thrombuses

Answer 8

hypercoagulability and stasis

Question 9

give 2 exmples of a venous thrombus

Answer 9

DVT and pulmonary embolism

Question 10

give 5 risk factors for a venous thrombus

Answer 10

pregnancy, hormone therapy, immobility, surgery and obesity

Question 11

what scores can be used to assess the likelihood a DVT or PE

Answer 11

Wells score and geneva scores

Question 12

what is d-dimer

Answer 12

a product of fibrin breakdown

Question 13

what is fibrin

Answer 13

part of a clot - made from fibrinogen by thrombin

Question 14

what factors turns prothrombin into thrombin

Answer 14

factor X

Question 15

true/false - a +ve d-dimer is highly suggestive of a thrombosis

Answer 15

false - while a -ve result rules out thrombosis a +ve one can be caused by many things. therefore it is mainly used in cases with low likelihood of thrombosis to rule it out

Question 16

what disease is d-dimer diagnostic for

Answer 16

DIC

Question 17

3 types of anticoagulant

Answer 17

LMWH, warfarin and DOACs

Question 18

when would thrombolysis be indicated

Answer 18

in a massive PE

Question 19

how does warfarin work to prevents clots

Answer 19

inhibits factors II, VIII, IX and X

Question 20

what links factors II, VII, IX and X

Answer 20

they are all vitamin K dependent

Question 21

how does heparin work to prevent a clot

Answer 21

binds to antithrombin and increases its ability to attack thrombin and factor X

Question 22

what type of drug is rivaroxaban

Answer 22

a DOAC

Question 23

how do DOACs work

Answer 23

inhibit activated factor X

Question 24

what is DIC

Answer 24

a small vessel blood clot condition resulting in diffuse ischaemia

Question 25

why do you get bleeding in DIC

Answer 25

platelets and clotting factors become ‘exhausted’ and so you get bleeding

Question 26

treatment of bleeding DIC

Answer 26

FFP