venous/arterial thrombosis Flashcards
venous clots are rich in…
fibrin
presentation of DVT
hot, swollen, tender leg pain pitting oedema erythema unilateral
presentation of PE
pleuritic chest pain
CV collapse
haemoptysis
SOB
risk factors for VTE that cause blood stasis
age obesity pregnancy previous DVT/PE trauma/surgery malignancy paralysis
risk factors for VTE that cause vessel wall damage
age
previous VTE/PE
risk factors for VTE that cause hyper coagulability
age pregnancy puerperium oestrogen therapy trauma/surgery malignancy infection thrombophilia
how does anti-thrombin work
neutralises the enzymatic activity of thrombin (XI, IX, X)
how do protein C and S work
inhibit factors VIII and IX, and V and X
how are protein C and S activate
binding of thrombin to thrombomodulin
what is the effect of factor V Leiden
reduces the action of PC and PS on factors V and X
when should hereditary screening for thrombophilia be considered
venous thrombosis in patient <45 recurrent venous thrombosis unusual VT (eg upper limb) FHx of VT FHx of thrombophilia
management of thrombophilia
advice on avoiding risk
short term prophylaxis during periods of known risk
short term anticoagulation to treat thrombotic events
long term anticoagulation if recurrent thrombotic events
features of APS
recurrent thromboses (arterial and venous)
recurrent foetal loss
mild thrombocytopenia
which protein is affected in APS
B2 glycoprotein 1
risk factors for arterial thrombosis
hypertension
smoking
high cholesterol
diabetes mellitus
