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Path2201 > Topic 3: Thrombosis, Embolism, Infarction > Flashcards

Topic 3: Thrombosis, Embolism, Infarction Flashcards

1
Q

What is the definition of a thrombus?

A
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2
Q

What is the difference between a thrombus and a blood clot?

A
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3
Q

What is the normal response to haemorrhage? (3 steps)

A
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4
Q

Compare haemostasis and thrombosis?

A
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5
Q

What 4 factors inhibit thrombosis?

A
  • intact endothelial cells
  • anticoagulant molecules and platelet inhibition
  • fibrinolysis
  • lamina flow
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6
Q

What is Virchow’s triad?

A
  • factors that predispose you to thrombosis
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7
Q

What causes changes in the vessel wall?

A
  • injury to or activation of endothelium or exposure of subendothelial layers (collagen)
  • atherosclerosis *
  • inflammation
  • trauma (tumour)
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8
Q

Describe normal blood flow

A
  • laminar
  • keeps platelets away from endothelium
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9
Q

What causes stasis and turbulent flow (change in blood flow)?

A
  • disruption of laminar flow
  • endothelial activation
  • stasis is a major contributor to venous thrombi ( AKA clots)
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10
Q
A
  • veins
  • aneurysm, when you get an out pouch of a vessel, lose elasticity
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11
Q

What are changes in the constituents of blood?

A
  • hereditary (factor 5 mutations, deficiency of anticoagulant molecules)
  • acquired - more common (increase in coagulation factors, hyperviscosity- reduces flow)
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12
Q

what are 2 types of thrombi?

A
  • venous
  • arterial
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13
Q

What are the risk factors for developing DVT (deep vein thrombosis)?

A
  • immobilisation
  • post-surgical
  • cancer
  • pregnancy
  • heart failure
  • dehydration
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14
Q

What is trousseau syndrome?

A

when cancer causes venous thrombosis

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15
Q

What are the macroscopic signs of DVT?

A
  • attachment to valves
  • -
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16
Q

What are the microscopic signs of DVT?

A
  • full of red cells, darker area
  • lighter area, fibrin
  • irregular laminations
  • granulation tissue
  • attempted recanalisation (round empty spaces)
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17
Q

What are some outcomes of DVT?

A
  • resolution
  • granulation repair (origination)
  • recanalisation
  • goes into lungs, embolisation
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18
Q

What are some DVT clinical manifestations?

A
  • swollen
  • tender
  • identify predisposing factors
  • associated warms and redness
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19
Q

What are differential diagnoses of DVT?

A
20
Q

What are DVT investigations?

A
  • ultrasound shows the flow of the vein
  • plasma D-dimers (broken down fibrin) is a sign of inflammation and would rule out DVT in low-risk individuals
21
Q

How is DVT prevented?

A
22
Q

What is arterial thrombi?

A
  • lins of zahn
  • anurysm
23
Q

What is a microscopic featur of AT?

A
24
Q

What are the outcomes of arterial thrombus?

A
25
Q

What are the important sites of arterial thrombosis?

A
26
Q

What is a mural thrombus?

A
27
Q

Where and why does is a mural thrombus in the heart occur?

A
  • left ventricle after myocardial infarct
  • left atrium due to atrial fibrillation (change in flow)
  • vegetation on damaged valves
28
Q

What is a macroscopic feature of acute myocardial infarct?

A
  • yellow necrosis
  • acute
  • thrombus formed over it
  • may have caused death, due to decreased perfusion to organs or embolism
29
Q

What is the difference between thrombus and post-mortem clotting?

A
30
Q

Define embolism

A
  • transport by blood of abnormal material and its impaction in a vessel. at a point remote
31
Q

What are 3 kinds of embolism?

A
32
Q

What is venous thromboembolism?

A
  • ## dangerous when it gets to the level of the knee
33
Q

What is a pulmonary embolism?

A
34
Q

What is arterial thromboembolism?

A
  • moves with the flow of blood AWAY from the heart
  • lodges in arteries of matching size
  • ## causes distal ischaemia
35
Q

Discuss macroscopic feature of arterial thromboembolic in the heart

A
  • from mural thrombus in the left ventricle following myocardial infarction
36
Q

What is atherosclerosis?

A
  • 20% of arterial thromboembolism sources
37
Q

What are the effects of arterial thromboembolic in the leg, brain, kidney/ spleen and gut?

A
38
Q

What are the macroscopic features of mural thrombus in the left ventricle

A
  • old infarct, grey tissues due to decreased flow, loss of tissue, thin contracted ventricle wall
  • if it was recent would be yellow necrosis or hemorrhage
39
Q

Define infarction.

A
  • circumscribed area of ischaemic necrosis in an organ or tissue resulting from interference of blood
40
Q

What are some causes of infarction?

A
  • localised blockage of arterial supply
  • systemic hypotension
  • blockage of venous drainage
41
Q

What factors determine the effect of ischaemia?

A
  • rate of occlusion
  • extent of occlusion
  • systemic factors
  • anatomy of local blood supply
    (organs that have dual blood supply, liver, pulmonary and bronchial, and liver, systemic and portal)
  • vulnerability of tissue to ischaemia (brain, heart, huge metabolic requirements)
42
Q

What is venous occlusion?

A
  • can cause ischaemia due to back pressure and impairment of arterial flow
43
Q

What are torsion/volvulus and strangulation?

A
  • torsion of testis
44
Q

What are some macroscopic features of infarcts?

A
  • green
  • red
45
Q

What are the microscopic appearances of infarcts?

A
46
Q

What is the evolution of an infarct?

A

necrosis -> acute inflammatory response -> repair by granulation tissue

47
Q

What is the time course of infarction?

A

Path2201 (6 decks)

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