thrombotic disorders Flashcards
elements of haemostasis
primary heamostasis
coagulation cascase
fibrinolysis
primary haemostasis
in reponse to damaged vessel
vasoconstriction
platelet adhesion to collagen
platelet aggregation
coagulation cascade
to form fibrin –> stable clot
fibrinolysis
plasmin when plasminogen is activated (f11 + 12, urokinase, TPA)
breakdown of fibrin network
thrombus
clot arising in wrong place
e.g. DVT
thromboembolism
clot moving along vessel
e.g. DVT –> PE
virchow’s triad
stasis: bed rest, travel
hypercoaguability: pregnancy, trauma
vessel damage: atheroma
arterial thrombosus
white clot: mostly platelets and fibrin
most 2ry to atheroma
cause tissue ischaemia and infarction
arterial thrombosis risk factors
age smoking obese sedentary DM HTN high cholesterol FHx
arterial thrombosis management
1ry prevention: lifestyle, vascular risk factors
acute: thrombolysis, anti-platelets, anti-coags
2ry prevention
venous thrombosis
red clot: fibrin and red cells
stasis + hypercoagubility
back pressure
risk factors venous thrombosis
age pregnant hormonal Rx e.g. HRT tissue trauma surgery immobility obese systemic disease FHx
systemic disease + venous thrombosis
malignancy
myeloproliferative neoplasms
autoimmune e.g. IBD, SLE
diagnosis venous thrombosis
pre-test probability scoring: Wells, Geneva D-dimer doppler USS V/Q scan CT pulm anigo
aims of venous thrombosis Rx
prevent clot extension
prevent embolisation
prevent recurrence - longterm Rx