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29 Cards in this Set
- Front
- Back
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What are the 4 natural anticoagulants?
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tPA, ATIII, Protein C, Protein S
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What does tPA do?
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Natural clot buster, lyses clots, plasmin lyses fibrin
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What does ATIII do?
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Inhibits thrombin + 9a, 10a, 11a
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What condition is associated with ATIII deficiency?
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Severe form of thrombophilia
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How is protein C activated?
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Activated by binding of thrombin to thrombomodulin
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What do protein C and protein S do in combo?
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Inactivate Va, VIIIa
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What is the association with PAI and thrombi?
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PAI helps thrombi grow, fat activated PAI, so heavy people are more likely to clot
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What are the 2 products of a broken down clot?
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FDP's and d-dimer
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What is the definition of thrombosis?
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Formation of a clot within intact vascular system
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What is virchow's triad?
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Endothelial injury
Stasis or turbulence of blood Blood hypercoagulability |
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Where does thrombosis occur normally?
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In areas of abnormal blood flow
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What is an aneurysm?
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Outpouching of wall of artery
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What are the 6 hereditary thrombophilias and which is most common?
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Factor V Leiden mutation (most common)
Prothrombin 202210A mutation Hyperhomocysteinemia Protein C deficiency Protein S deficiency ATIII deficiency |
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What are the features of Factor V Leiden mutation?
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Recurrent DVT's
Single AA substitution results in factor Va resistant to digestion by activated protein C |
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What are the features of PT 20210A mutation?
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Inc levels of PT
High PT levels drive more fibrinogen --> fibrin 2x risk of venous thrombosis |
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When would you consider diagnosis of an inherited thrombophilia?
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Thrombosis under age 50, esp in kids, unusual recurrent sites of thrombosis, thrombosis in pregnancy/postpartum, thrombosis with no acquired predisposition
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What is the highest risk cause of secondary hypercoagulability?
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Prolonged bed rest
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What is HIT and what are its features?
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Heparin Induced Thrombocytopenia
AB's form to unfractionated heparin These AB's recognize and bind to heparin-platelet factor 4 Binding activates platelets --> formation of platelet rich thrombi |
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What is the pathogenesis of antiphospholipid syndrome?
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Recurrent venous or arterial thrombi
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What are some unique clinical features of antiphospholipid syndrome?
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Repeated spontaneous abortions
Libman-sachs cardiac valvular vegetations Thrombocytopenia |
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What is the most common kind of embolus, where does it come from and what are the symptoms?
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Venous thrombosis embolizes
From deep veins in the legs Edema, swelling in leg Homan's sign |
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What lab value excludes DVT if normal?
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D-dimer
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Venous thrombi extend in which direction?
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In the direction of blood flow
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Arterial thrombi extend in which direction?
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Extend retrograde
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What are Lines of Zahn?
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Alternating layers of RBC's and platelets in thrombi formed in heart, aorta, flowing blood
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What are the 4 fates of thrombi?
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Dissolution / Resolution
Embolization Organized and Incorporated into the wall Organized and recanalized |
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What is an embolus?
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Detached solid, liquid or gas mass that is carried by blood to a site distant from origin
Anything that is not blood |
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What is a thromboembolism?
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Embolus of blood clot
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What is cor pulmonale?
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Hypertrophy of RV from lung disease --> leads to right heart failure
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