Venous Thrombosis Flashcards
Where is the most common site of venous thrombosis?
Deep veins of the leg
What are the 3 factors in Virchow’s triad?
Endothelial dysfunction or injury
Hypercoagulability of blood
Changes in blood flow
How is blood flow commonly changed in the pathogenesis of VTE?
Slowed, due to impaired mobility, polycythaemia, HF or dehydration
What are some common causes of endothelium dysfunction or injury in the pathogenesis of VTE?
Direct trauma
Surgical trauma
Injury from catheters
What are some common causes of hypercoagulability in the pathogenesis of VTE?
Post-operative/post-traumatic states (esp burns) Post-MI Malignancy High oestrogens Anti-phospholipid antibody syndrome Nephrotic syndrome Obesity Certain inflammatory diseases Genetic/inherited causes
Give some common examples of genetic/inherited causes of hypercoagulability
Factor V Leiden mutation (prevents inactivation)W
PT mutation
Deficiencies of anti-thrombin, protein C, protein S
High factor VIII
List 5 common causes of thrombophilia
Genetic/inherited causes of hypercoagulability Malignancy Anti-phospholipid syndrome Pregnancy and high oestrogens Other
What is the difference between thrombophilia and hypercoagulability?
Thrombophilia is a long term increased risk
Hypercoagulabilities can be transient (e.g. in MI)
What are some of the symptoms of DVT?
Swelling, redness, warmth, discomfort, pain, tenderness
Can be asymptomatic
What are some of the long term outcomes of DVT?
Fibrinolysis, organisation and complete/partial recanalisation of thrombus
Damaged incompetent valves leading to varicose veins or chronic venous insufficiency
What is chronic venous insufficiency?
Decreased venous return leading to pooling of blood in the lower limbs and symptoms such as pruritis, ulceration, hyperpigmentation and swelling
How can DVT be prevented?
Pharmacological prophylaxis Mobilisation Exercises Compression stockings Lifestyle changes
What are some other common sites of venous thrombosis?
Veins of upper limb Cerebral venous sinuses Mesenteric veins Portal vein Hepatic veins
