Venous Thrombosis

Question 1

Is it platelets or fibrin than are the problem in arterial thrombosis?

Answer 1

Platelets

Question 2

Are arterial thrombi venous or platelet rich?

Answer 2

Platelet

Question 3

What are the tretament for arterial thrombus prevention?

Answer 3

Aspririn and other anti platelet drugs?

Question 4

Are venous thrombus rich in platelets or fibrin?

Answer 4

Fibrin

Question 5

Is it platelets or fibrin than are the problem in venous thrombosis?

Answer 5

Fibrin

Question 6

What are the three components of virchow’s triad?

Answer 6

Stasis
Vessel wall damage
Hypercoaguability

Question 7

What side of the hear is under strain if there is a PE?

Answer 7

Right

Question 8

What are the risk factors for a DVT?

Answer 8

Age
Marked obesity
Pregnancy
Puerperium
Oestrogen therapy
Previous DVT/PE
Trauma/Surgery
Malignancy
Paralysis
Infection
Thrombophilia

Question 9

Why is age a major risk factor for a DVT?

Answer 9

Valves don’t function as well as you get older.

Question 10

What hormone raises the risk of a DVT?

Answer 10

Oestrogen

Question 11

Familial or acquired disorders of the haemostatic mechanism which are likely to predispose to thrombosis.

Answer 11

Thrombophillia

Question 12

What protein is responsible for switching of thrombin formation?

Answer 12

Anti thrombin 3

Question 13

What does anti thrombin 3 do?

Answer 13

Switch of thrombin formation

Question 14

What happens if you have a Factor V Leiden Mutation?

Answer 14

More likely to have a VTE (Factor 5 isn’t switched off as easily)

Question 15

What are the 5 main hereditary thrombophilias?

Answer 15

Factor V Leiden
Prothrombin 20210 mutation
Antithrombin deficiency
Protein C deficiency
Protein S deficiency

Question 16

When should you consider testing someone for a hereditary thrombophilia?

Answer 16

Venous thrombosis

Question 17

How do you manage hereditary thombophilia?

Answer 17

• Advice of avoiding risk
  (eg avoid COCP)
  Heparin at high risk times eg after surgery, after delivery
• Long term anticoagulation for thoses at highest risk of multiple events (usually after they have had one!) with heparin or warfarin.

Question 18

A patient aged 40 has had a TIA. She has also had a DVT in the past and 3 miscarriages.

Answer 18

Antiphospholipid syndrome

Question 19

Does having antiphospholipid antibodies activate primary or secondary haemostasis, or both?

Answer 19

Both

Question 20

What is the APPT like in antiphospholipid syndrome?

Answer 20

Prolonged

Question 21

Where is there a conformational change in antiphospholipid syndrome?

Answer 21

Beta 2 glycoprotein