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19 Cards in this Set
- Front
- Back
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What are the three components of Virchow's Triad?
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Stasis,
Vessel wall injury, Thrombophilia |
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What are the elements of the Virchow's triad?
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Stasis
vessel wall injury Thrombophilia |
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What are the characteristics of ARTERIAL thrombosis?
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Platelet-driven, often related to atherosclerosis
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What are the characteristics of ARTERIAL thrombosis?
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platelet-driven, generally associated with atherosclerosis
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What role do adiponectin and PAI-1 play in obesity-related atherothrombosis?
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When adipose tissue increases:
Adiponectin decreases, which leads to increased plt aggregation and increased inflammation; PAI-1 increases, which decreases fibrinolysis |
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How do adiponectin and PAI-1 play a role in obesity-related atherothrombosis?
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When adipose tissue accumulates:
adiponectin decreases, which increases plt aggregation and inflammation PAI-1 increases, which decreases fibrinolysis |
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Describe the pathogenesis of May-Thurner syndrome and central retinal vein thrombosis
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high pressure arteries cross over veins (in the case of M-T syndrome, the right iliac a crosses the left iliac v), causing venous stasis and vessel wall injury
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What occurs in the valve sinus of veins to prevent thrombosis?
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low vWF expression, elevated endothelial protein C receptor and thrombomodulin
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Explain why factor V Leiden leads to (modestly) increased risk of thrombosis
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more resistant to protein C cleavage and does not participate in factor 8 cleavage (which normal factor 5 does)
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Is there a benefit to factor V Leiden in the face of the increased risk of thrombosis?
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Decreased incidence of intracranial hemorrhage in newborns
Decreased bleeding during pregnancy |
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Explain why prothrombin 20210 increases the risk of thrombosis?
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Mutation in the promoter region leads to increased synthesis of prothrombin--> increased TAFI which also decreases fibrinolysis
(homozygotes high risk for thrombosis) |
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What are the consequences of homozygous and heterozygous inheritance of protein C and S deficiency?
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Homozygous: widespread, lethal (if untreated) thrombosis in baby: purpura fulminans
Heterozygotes: likely develop venous thrombosis during lifetime |
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Signs of antithrombin deficiency?
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early-in-life thrombosis
pregnancy losses resistance to heparin (but need to be on lifetime anticoagulation therapy) |
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A gain of function in which coagulation factor is associated with increased risk of venous thrombosis?
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Factor 8
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The accumulation of which metabolite is associated with endothelial damage (decreases NO, TM, and PG2) and an increased risk in both arterial and venous thrombosis?
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homocysteine (interestingly, treatment with B12 and folate decrease homocysteine but not thrombosis risk)
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What criteria should be used to screen patients for inherited thrombophilia?
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F = family history
U = unusual location of thrombus R = recurrent episodes Y = young (<40 y/o) |
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What does prothrombin 20210 lead to increased risk of thrombosis?
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Mutation in promoter region leads to increased production of prothrombin --> increased thrombin --> increased TAFI --> decreased fibrinolysis
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Gain of function of which clotting factor leads to thrombophilia?
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Factor 8
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When is it appropriate to screen for inherited thrombophilia?
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F = family history
U = unusual thrombosis R = recurrent episodes Y = young (<40 y/o) |
