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Haematology HK > Venous thrombosis > Flashcards

Venous thrombosis Flashcards

1
Q

what is affected in arterial thrombosis

A

atherosclerosis in high pressured system - affects PLATELETS

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2
Q

what is affected in venous thrombosis

A

low pressured system affecting COAGULATION (secondary haemostasis)

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3
Q

what drug class is given in arterial thrombosis

A

antiplatelet (aspirin)

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4
Q

what drug class is given in venous thrombosis

A

anticoagulants:
acute - heparin
long term - warfarin

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5
Q

what is Virchow’s triad

A

stasis of blood
vessel wall abnormalities
hypercoaguable state

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6
Q

risk factors for stasis of blood

A 
immobility
increased age
obesity
pregnancy
trauma/surgery/previous VTE
paralysis
malignancy
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7
Q

risk factors for vessel wall abnormalities

A

increased age

previous VTE

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8
Q

risk factors for hypercoaguable state

A 
age 
pregnancy/puerperium 
oestrogen therapy
trauma/surgery
malignancy
infection
thrombophilia
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9
Q

presentation of DVT

A

hot
swollen
tender
pitting oedema

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10
Q

presentation of PE

A

pleuritic chest pain
worse on breathing
hypoxia

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11
Q

what is thrombophilia

A

disorders affecting haemostasis to cause thrombosis

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12
Q

what are the hereditary thrombophilias

A 
anti-thrombin III deficiency 
protein C deficiency 
protein S deficiency 
factor V leiden 
prothrombin 20210 mutation
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13
Q

what does antithrombin III act on

A

activated clotting factors - VIIa, IIa, Xa, VIIIa and IXa

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14
Q

what do proteins C and S work on

A

factors V and VIII

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15
Q

what is factor V leiden

A

single base change in factor V

protein C and S cant switch it off

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16
Q

when should someone be screened for hereditary thrombophilia

A

VTE <45 years
recurrent VTEs
VTEs in unusual places
family history of VTEs or thrombophilia

17
Q

management of patients with inherited thrombophilia

A 
avoiding risks (eg oestrogen and HRT, weight loss etc)
short term prophylaxis in times of higher risk (surgery, pregnancy)
long term anticoagulation if recurrent
18
Q

what is antiphospholipid syndrome

A

connective tissue disease

19
Q

pathophysiology of antiphospholipid syndrome

A

anticardiolipin antibodies cause a conformational change in B2 glycoprotein1
activates primary and secondary haemostasis and causes vessel wall abnormalities (acts on phospholipids)

20
Q

how does antiphospholipid syndrome present

A

recurrent arterial AND venous thrombosis
recurrent foetal loss
mild thrombocytopenia

21
Q

management of antiphospholipid syndrome

A

antiplatelet AND anticoagulation

Haematology HK (22 decks)

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