thrombus and emboli

Question 1

terminology - thrombus

Answer 1

stationary solid blood clot that can form outside the vessel, in the wall or in the lumen

Question 2

terminology - haemorrhage

Answer 2

blood leaving a damaged vessel

Question 3

terminology - exsanguination

Answer 3

extreme blood loss caused by traumatic injury often resulting in death if blood not replaced within a few minutes

Question 4

terminology - coagulation

Answer 4

the process
of forming a clot (a thrombus)

Question 5

terminology - hypercoagulability

Answer 5

having an increased likelihood of clots

Question 6

terminology - haemostasis

Answer 6

cessation of bleeding and free flow of blood without any clots

Question 7

rudolf virchow coined the terms…

Answer 7

thrombosis + embolism

Question 8

virchows triad

Answer 8

• Three factors predispose patients to thrombosis.
• They are stasis, hypercoagulability, and vascular endothelium
• These are commonly referred to as Virchow’s triad.
• if factors intersect they increase risk of thrombosis occuring

Question 9

Virchow’s Triad

endothelial injury caused by trauma

Answer 9

• injury
• venepuncture

Question 10

virchow’s triad

endothelial injury caused by pathology

Answer 10

• cellulitis
• thrombophlebitis
• artherosclerosis

Question 11

virchow’s triad

endothelial injury exacerbated by

Answer 11

• inflammation
• infection
• toxins from cigarettes

Question 12

virchow’s triad

blood stasis - blood flow can become

Answer 12

turbulent/impaired blood flow

Question 13

virchow’s triad

blood stasis causes - arterial thrombus

Answer 13

• atrial fibrillation
• athersclerotic plaques
• aortic aneurysm

all lead to turbulent flow - arterial thrombus

Question 14

virchow’s triad

blood stasis causes - venous thrombus

Answer 14

• mural thrombus after cardiac arrest
• mitral valve stenosis
• polycythaemia

leads to stasis of blood - venous thrombus

Question 15

arterial vs veinous thrombi

Answer 15

Question 16

virchow’s triad

lines of zhan

Answer 16

• characteristic of thrombi
• have layers, with lighter layers of platelets and fibrin, and darker layers of red blood cells.
• they are more present on thrombi formed with faster blood flow, more so on thrombi from the heart and aorta.
• they are only seen on thrombi formed before death.

Question 17

virchow’s triad

hypercoagualability also called

Answer 17

thrombophilia

Question 18

causes of hypercoagulability

Answer 18

• Trauma
• major surgery
• pregnancy
• inherited thrombophilia
• infection

Question 19

hypercoagulability states

Answer 19

Question 20

fate of thrombus - progression that a blood clot goes through while it is present in the body

Answer 20

• Dissolved by fibrinolysis
• Propagation into a larger clot
• Recanalization into the wall which will re-establish patency of the lumen or use of another pathway
• Dislodged and embolization

Question 21

what is an embolism?

Answer 21

detached intravascular solid, liquid or gaseous mass that is carried by the blood to another site

Question 22

pulmonary embolism

Answer 22

• cause - venous thrombus embolus from deep leg vein
• common in hospitalised patients and those at home who are immobile
• Often there are multiple emboli

Question 23

fat embolism

Answer 23

Question 24

gas embolism

Answer 24

• small volume of air trapped in coronary artery during bypass surgery
• chest wall injury
• obstetric procedures
• decompression sickness - caissons disease

Question 25

amniotic fluid embolism

Answer 25

• during labour or immediate post partum period
• infusion of amniotic fluid or fetal tissue into maternal circulation via tear in placental membranes or rupture of uterine veins