Thrombotic disorders

Question 1

the elements of haemostasis

Answer 1

primary haemostasis
blood coagulation
fibrinolysis - clot degradation

Question 2

primary haemostasis leads to?

Answer 2

vasoconstriction
platelet adhesion - endothelial college - protein 1A
platelet aggregation

Question 3

the coagulation cascade causes?

Answer 3

formation of fibrin

cross links to form stable clot

Question 4

what components transfer plasminogen to plasmin

Answer 4

urokinase
TPA
FXIIa and FXIa

Question 5

what is virchows triad

- what can cause them?

Answer 5

stasis - bed rest travel

hypercoagulability - pregnancy, trauma, HRT, trauma

vessel damage - atherosclerosis

Question 6

arterial thrombus - consist of?

secondary to?

Answer 6

platelets and fibrin

tissue ischemia and infarction

atherosclerosis

Question 7

Cerbrovascular thromboembolism can manifest?

Answer 7

stroke

transient ischaemia

Question 8

peripheral embolism can present as?

Answer 8

acute limb ischemia

Question 9

Management of arterial thrombosis

Answer 9

primary - lifestyle change
- treatment of vascular risk factors

acute - thrombolysis - anti platelet and anticoagulants

secondary - identify risk factors

Question 10

venus thrombus is?

- back pressure due to?

Answer 10

fibrin and red cells

• back pressure
• stasis and hypercoagulability

Question 11

types of venous thrombus

Answer 11

limb DVT
pulmonary embolism
visceral venous
intracranial 
superficial thrombophlebitis

Question 12

risk factors for venous thrombosis?

Answer 12

increasing age
obesity 
hornmal (COCP/HRT)
pregnancy 
immobility
surgery

Question 13

systemic disease causing venous thrombosis

Answer 13

cancer and MPN

AUTOIMMUNE

• IBD
• SLE

Question 14

diagnosis of venous thrombosis?

Answer 14

wells score
geneva score

lab testing - D-dimer

• imaging

Question 15

venous thrombosis imaging?

gold standard?

Answer 15

doppler ultrasonography

lung - V/Q scan

CT pulmonary angiogram

Question 16

what anticoagulants do we give for Venous thrombosis?

Answer 16

LMW heparins
Warfarin - vit K antagonist
DOACS

• prevent original clot from extending, don’t break down the clot

alteplase etc- break down the clot

Question 17

massive PE’S need?

Answer 17

thrombolysis

Question 18

heritable thrombophilia

Answer 18

factor v LEIDEN

Prothromin gene

protein C,S and antithrombin deficiency

Question 19

factor v LEIDEN has..

Answer 19

protein C resistance

- VIIIa and Va inhibited

Question 20

what is microvascular thrombus

Answer 20

platelets and fibrin

- diffuse ischemia (intensive care patients)

Question 21

when does DIC occur?

Answer 21

speticaemia, meningitis

• malignancy -acute and chronic
• eclampsia

Question 22

what does DIC cause?

Answer 22

• tissue ischemia
• gangrene
• organ failure - microvascular thrombosis
• thrombocytopenia and factor deficiency - bleeding