Thrombotic Disorders

Questions and Answers

What is the correct sequence of steps involved in normal haemostasis after blood vessel injury?

Platelet activation, Platelet aggregation, Coagulation, Platelet secretion

Collagen exposed, Platelet adhesion, Platelet activation, Fibrin strands trap cells

Collagen exposed, Platelet adhesion, Platelet activation, Platelet secretion, Platelet aggregation, Coagulation (correct)

Coagulation, Platelet adhesion, Collagen exposed, Platelet aggregation

Which of the following is a pathological consequence of arterial thrombosis?

Deep Vein Thrombosis

Pulmonary Embolism

Varicose Veins

Myocardial Infarction (correct)

What initiates the process of platelet activation following blood vessel injury?

Exposure of collagen (correct)

Aggregation of platelets

Formation of thrombus

Secretion of fibrinogen

Which of the following symptoms is indicative of ischaemic stroke related to arterial thrombosis?

Sudden difficulty with vision Signup and view all the answers

In the context of arterial thrombosis, what role do fibrin strands play?

They trap cells to form a stable clot Signup and view all the answers

What is a common probable cause of arterial thrombosis?

Inappropriate activation of platelets Signup and view all the answers

What symptom is associated with peripheral arterial disease (PAD)?

Pain or cramping in the legs during activity Signup and view all the answers

Which factor primarily contributes to the inappropriate activation of platelets in arterial thrombosis?

Atherosclerosis Signup and view all the answers

What symptom is commonly associated with myocardial infarction (MI) that may radiate to different parts of the body?

Central chest pain Signup and view all the answers

What is one sign of arterial thrombosis in the case of ischemic stroke?

Slurred speech Signup and view all the answers

Which diagnostic method is essential for confirming an ischemic stroke?

Neuroimaging (CT or MRI) Signup and view all the answers

What treatment option is typically used for arterial thrombosis in the case of myocardial infarction?

Thrombolytic therapy Signup and view all the answers

What does Virchow's Triad not include as a component contributing to venous thrombosis?

Elevated D-dimers Signup and view all the answers

What is a common risk factor for developing deep vein thrombosis (DVT)?

Long-distance travel Signup and view all the answers

Which of the following is a common sign of pulmonary embolism (PE)?

Chest pain during deep breathing Signup and view all the answers

What percentage of patients experience post-thrombotic syndrome after deep vein thrombosis (DVT)?

40% Signup and view all the answers

What is the annual incidence of venous thrombosis?

1-3 cases per 1000 individuals Signup and view all the answers

What is a defining symptom of deep vein thrombosis (DVT)?

Pain in the leg Signup and view all the answers

Which factor is NOT a common cause of venous thrombosis?

Physical activity Signup and view all the answers

What is the risk of fatal pulmonary embolism (PE) following deep vein thrombosis (DVT)?

3% Signup and view all the answers

What does thrombophilia refer to in the context of venous thrombosis?

Increased long-term risk of venous thromboembolism Signup and view all the answers

What is the primary inheritance pattern of Anti-thrombin III Deficiency?

Autosomal dominant disorder Signup and view all the answers

What is the prevalence of Protein C Deficiency in the population?

1 in 500 Signup and view all the answers

Which deficiency is characterized by an increased risk of venous thrombosis by 10-15 times?

Protein C Deficiency Signup and view all the answers

How many types of Protein S Deficiency exist?

3 types Signup and view all the answers

What is the estimated risk of developing a clot for individuals with Anti-thrombin III Deficiency?

50% Signup and view all the answers

Which factor demonstrates the highest increased risk for venous thrombosis in homozygotes?

Factor V Leiden Signup and view all the answers

What is one potential outcome of dysfunctional fibrinogen in Dysfibrinogenemia?

Hemorrhage in 50% of cases Signup and view all the answers

In which demographic are protein S levels generally higher?

Adult males Signup and view all the answers

What condition is associated with compression of the left common iliac vein?

Congenital anatomic variation Signup and view all the answers

How does age contribute to acquired thrombophilia?

Stasis in the venous system Signup and view all the answers

Which acquired risk factor increases the likelihood of thrombosis fourfold?

Malignancy Signup and view all the answers

Which Medications are known to associate with increased risk of acquired thrombophilia?

Oral contraceptives Signup and view all the answers

What is the frequency of the Prothrombin G20210A allele in the population?

1 in 50 Signup and view all the answers

What role does activated protein C play in the clotting process?

Cleaves FV or FVIII Signup and view all the answers

Which clotting factors are increased by estrogen therapy?

Factors II, VII, VIII, IX, and X Signup and view all the answers

What effect does estrogen therapy have on anti-thrombin III levels?

Decreases levels Signup and view all the answers

In which scenarios do protein S levels notably decrease?

In pregnancy and hormone replacement therapy Signup and view all the answers

What are common effects caused by Antiphospholipid Antibody Syndrome in vivo?

Increased arterial and venous thrombosis Signup and view all the answers

What condition is characterized by a raised platelet count above 150-400 x 10^9/L?

Essential Thrombocytosis Signup and view all the answers

Which of the following is a characteristic of Polycythemia Rubra Vera?

Excess production of red blood cells Signup and view all the answers

What is a potential consequence of blood thickening in Polycythemia Rubra Vera?

Increased risk of thrombosis Signup and view all the answers

Why might urine appear darker in the morning in individuals with Paroxysmal Nocturnal Hemoglobinuria?

Urine concentration due to overnight lysis of RBCs Signup and view all the answers

Which of the following is NOT associated with Antiphospholipid Antibody Syndrome?

Increased hemoglobin levels Signup and view all the answers

Which type of disorder is Essential Thrombocytosis classified as?

Myeloproliferative neoplasms Signup and view all the answers

What is the first step that occurs in the normal haemostasis process following blood vessel injury?

Collagen exposed Signup and view all the answers

What mechanism facilitates the trapping of cells to form a stable thrombus?

Coagulation Signup and view all the answers

Which of the following is NOT a symptom associated with myocardial infarction (MI)?

Sudden weakness or numbness of the face Signup and view all the answers

What condition is primarily associated with the inappropriate activation of platelets in arterial thrombosis?

Atherosclerosis Signup and view all the answers

What is a common symptom of peripheral arterial disease (PAD)?

Pain in the legs during physical activity Signup and view all the answers

Which of the following best outlines the pathological consequences of venous thrombosis?

Deep Vein Thrombosis and Pulmonary Embolism Signup and view all the answers

What symptom is commonly found in ischaemic stroke due to arterial thrombosis?

Facial drooping on one side Signup and view all the answers

What could likely occur as a consequence of arterial thrombosis?

Reduction in blood supply to limbs Signup and view all the answers

What effect does estrogen therapy have on tissue plasminogen activator (tPA) levels?

Decreases tPA levels Signup and view all the answers

What is the percentage of the healthy population that has antiphospholipid antibodies?

5% Signup and view all the answers

Which condition is associated with increased arterial and venous thrombosis in vivo?

Antiphospholipid Antibody Syndrome Signup and view all the answers

In which condition do protein S levels decrease?

Pregnancy Signup and view all the answers

What characterizes Paroxysmal Nocturnal Hemoglobinuria (PNH)?

Lysis of red blood cells causing hemoglobinuria Signup and view all the answers

What is the main underlying defect in Paroxysmal Nocturnal Hemoglobinuria?

Defect in forming GPI-anchors Signup and view all the answers

Which of the following is NOT a type of myeloproliferative neoplasm?

Aplastic Anemia Signup and view all the answers

Which acquired risk factor is associated with an increased likelihood of thrombosis?

Hormone replacement therapy Signup and view all the answers

What percentage of young myocardial infarction (MI) patients have antiphospholipid antibodies?

21% Signup and view all the answers

What type of deficiency is Anti-thrombin III Deficiency classified as?

Both quantitative and qualitative deficiency Signup and view all the answers

What is the estimated lifetime risk of developing a clot for individuals with Anti-thrombin III Deficiency?

50% Signup and view all the answers

What is the prevalence of Protein C Deficiency in the general population?

1 in 500 Signup and view all the answers

How many types of Protein S Deficiency exist?

3 types Signup and view all the answers

What inheritance pattern is associated with Factor V Leiden?

Autosomal dominant disorder Signup and view all the answers

What is the prevalence of Prothrombin G20210A allele in the population?

1 in 50 Signup and view all the answers

What effect does the Prothrombin G20210A allele have on prothrombin levels?

Elevates prothrombin levels Signup and view all the answers

What is one of the major risk factors for acquired thrombophilia?

Age Signup and view all the answers

Which of the following is associated with an increased risk of venous thrombosis in individuals with Factor V Leiden?

3-5 times for heterozygotes Signup and view all the answers

What is the inheritance pattern of Dysfibrinogenemia?

Autosomal dominant disorder Signup and view all the answers

In which conditions do protein S levels typically drop?

During pregnancy and hormonal therapy Signup and view all the answers

Which congenital anatomic variation is associated with inherited thrombophilia?

Compression of the left common iliac vein Signup and view all the answers

What is the strongest risk factor for acquired thrombophilia?

Previous thrombosis Signup and view all the answers

What are some common signs of arterial thrombosis in myocardial infarction (MI)?

Pale skin and sweating Signup and view all the answers

Which diagnostic method is commonly used to confirm myocardial infarction?

Electrocardiogram (ECG) and serum markers Signup and view all the answers

What is a potential long-term consequence of deep vein thrombosis (DVT)?

Post-thrombotic syndrome Signup and view all the answers

Which treatment option is typically NOT associated with myocardial infarction?

Carotid endarterectomy Signup and view all the answers

What is the defining clinical tool used to assess symptoms of an ischemic stroke?

FAST (Face, Arm, Speech, Time) Signup and view all the answers

What characterizes the symptoms of deep vein thrombosis (DVT)?

Hot, red, swollen, painful leg Signup and view all the answers

What are the key components of Virchow's Triad in relation to venous thrombosis?

Endothelial damage, stasis, and hypercoagulability Signup and view all the answers

What is a major complication associated with venous thrombosis?

Pulmonary embolism (PE) Signup and view all the answers

Which symptom is indicative of pulmonary embolism (PE)?

Shortness of breath and chest pain Signup and view all the answers

What is the estimated incidence of venous thrombosis on an annual basis?

1-3 cases per 1000 individuals Signup and view all the answers

What is the prognosis for a patient after their first myocardial infarction?

13% die during hospital admission Signup and view all the answers

What immediate symptom is often present in an ischemic stroke?

Face asymmetries Signup and view all the answers

What is the primary treatment approach for deep vein thrombosis (DVT)?

Anticoagulation and thrombolytic therapy Signup and view all the answers

How is arterial thrombosis diagnosed in ischemic stroke?

By neuroimaging to differentiate types of stroke Signup and view all the answers

What underlying factor can lead to venous thrombosis in a patient?

Dehydration Signup and view all the answers

Study Notes

Steps of Normal Haemostasis

Collagen is exposed upon blood vessel injury, initiating haemostasis.
Platelet adhesion occurs as platelets bind to exposed collagen.
Platelet activation follows, triggering a cascade of chemical signals.
Platelet secretion releases various substances that further attract and activate additional platelets.
Platelet aggregation happens as platelets clump together to form a primary plug.
Fibrin strands form through coagulation, stabilizing the clot by trapping cells.
This leads to the formation of a stable clot or thrombus.

Physiological Processes of Blood Vessel Injury

Exposure of collagen activates platelets, leading to their adhesion, activation, secretion, and aggregation, followed by coagulation.

Mechanism of Clot Stabilization

Coagulation results in the formation of fibrin strands that encapsulate and trap blood cells, solidifying the clot structure.

Consequences of Arterial Thrombosis

Involves risks such as myocardial infarction (MI), ischemic stroke, and peripheral arterial disease (PAD), primarily due to atherosclerosis.

Inappropriate Activation of Platelets

Arterial thrombosis triggered by inappropriate platelet activation due to:
- Atherosclerosis in arteries.
- Rupture of atherosclerotic plaques, releasing thrombogenic lipids.

Symptoms of Ischemic Stroke

Sudden weakness or numbness in the face, arm, or leg, often unilateral.
Speech difficulties and confusion.
Vision problems in one or both eyes.

Symptoms of Peripheral Arterial Disease (PAD)

Claudication: leg pain or cramping during activity.
Weakness or numbness in legs.
Non-healing sores on legs/feet and temperature variations.

Symptoms of Myocardial Infarction (MI)

Central chest pain radiating to arms, back, neck, jaw, or stomach.
Accompanied by shortness of breath, sweating, nausea, and anxiety.

Signs of Myocardial Infarction (MI)

Tachycardia, low-grade fever, pale clammy skin, changes in blood pressure, altered heart sounds.

Diagnosis of Myocardial Infarction (MI)

Confirmed through ECG readings and elevated troponin and creatine kinase levels.

Treatment Options for Myocardial Infarction (MI)

Thrombolytic therapy, anti-platelet medications, beta-blockers, percutaneous coronary intervention (PCTA), and coronary artery bypass grafting (CABG).

Prognosis After First Myocardial Infarction (MI)

23% may die before reaching the hospital.
13% die during hospitalization.
10% die within the first year post-discharge, with a continuous 5% risk annually thereafter.

Ischemic Stroke Diagnosis

Based on clinical signs and symptoms, confirmed through neuroimaging (CT/MRI) to differentiate stroke types.

Treatment Options for Ischemic Stroke

Thrombolytic therapy, anti-platelet therapies, and carotid endarterectomy.

Prognosis After Ischemic Stroke

Complete recovery occurs in about 10% of cases.
Significant long-term deficits are common, with an increased risk of subsequent strokes. Hospital mortality is 20%.

Causes of Venous Thrombosis

Risk factors include stasis (immobility), endothelial damage, and hypercoagulability contributing to Virchow's Triad.

Symptoms of Venous Thrombosis

Pain and tenderness in affected leg.
Swelling, redness, and warmth, typically unilateral.

Signs of Deep Vein Thrombosis (DVT)

Increased temperature, general malaise, elevated white blood cell count, and elevated erythrocyte sedimentation rate (ESR).

Diagnosis of Deep Vein Thrombosis (DVT)

Confirmed via ultrasound, venogram, and elevated D-dimer levels.

Treatment Options for Deep Vein Thrombosis (DVT)

Anti-coagulation therapy and thrombolytic treatment.

Prevention Measures for Deep Vein Thrombosis (DVT)

Encouraging leg exercises, using support stockings, and prescribing prophylactic anti-coagulation.

Prognosis of Deep Vein Thrombosis (DVT)

3% risk of fatal pulmonary embolism (PE).

Annual Incidence of Venous Thrombosis

Ranges from 1 to 3 cases per 1000 individuals.

Major Complications of Venous Thrombosis

Associated with post-thrombotic syndrome in 40% of cases and a 3% mortality rate.

Thrombophilia Overview

Refers to congenital or acquired conditions that increase the risk of venous thromboembolism.

Congenital Thrombophilia Causes

Include deficiencies in antithrombin, protein C, protein S, Factor V Leiden, Prothrombin G20210A, and Dysfibrinogenemia.

Acquired Thrombophilia Factors

Prior thrombosis, age, immobilization, surgery, malignancy, and hormonal therapies increase thrombotic risk.

General Impact of Hormone Therapy

Estrogen can increase clotting factor levels while decreasing levels of anti-thrombin III and protein S, heightening thrombosis risk.

Antiphospholipid Antibody Syndrome

Involves autoantibodies leading to increased risk of both arterial and venous thrombosis and associated with pregnancy complications.

Essential Thrombocytosis (Thrombocythemia)

Characterized by elevated platelet counts, risk of thrombosis or bleeding, classified as a myeloproliferative neoplasm.

Polycythemia Rubra Vera

Elevation of red blood cells leading to blood thickening, diagnosed by high hematocrit and hemoglobin levels.

Paroxysmal Nocturnal Hemoglobinuria (PNH)

Condition leading to RBC lysis, hemoglobinuria, and risks of venous thrombosis and bone marrow failure.

Summary of Thrombophilia Factors

Inherited thrombophilia syndromes (e.g., deficiencies in various coagulation factors) and acquired factors (e.g., past thrombosis, malignancy) contribute to thromboembolic risk.

Steps of Normal Haemostasis

Collagen is exposed upon blood vessel injury, initiating haemostasis.
Platelet adhesion occurs as platelets bind to exposed collagen.
Platelet activation follows, triggering a cascade of chemical signals.
Platelet secretion releases various substances that further attract and activate additional platelets.
Platelet aggregation happens as platelets clump together to form a primary plug.
Fibrin strands form through coagulation, stabilizing the clot by trapping cells.
This leads to the formation of a stable clot or thrombus.

Physiological Processes of Blood Vessel Injury

Exposure of collagen activates platelets, leading to their adhesion, activation, secretion, and aggregation, followed by coagulation.

Mechanism of Clot Stabilization

Coagulation results in the formation of fibrin strands that encapsulate and trap blood cells, solidifying the clot structure.

Consequences of Arterial Thrombosis

Involves risks such as myocardial infarction (MI), ischemic stroke, and peripheral arterial disease (PAD), primarily due to atherosclerosis.

Inappropriate Activation of Platelets

Arterial thrombosis triggered by inappropriate platelet activation due to:
- Atherosclerosis in arteries.
- Rupture of atherosclerotic plaques, releasing thrombogenic lipids.

Symptoms of Ischemic Stroke

Sudden weakness or numbness in the face, arm, or leg, often unilateral.
Speech difficulties and confusion.
Vision problems in one or both eyes.

Symptoms of Peripheral Arterial Disease (PAD)

Claudication: leg pain or cramping during activity.
Weakness or numbness in legs.
Non-healing sores on legs/feet and temperature variations.

Symptoms of Myocardial Infarction (MI)

Central chest pain radiating to arms, back, neck, jaw, or stomach.
Accompanied by shortness of breath, sweating, nausea, and anxiety.

Signs of Myocardial Infarction (MI)

Tachycardia, low-grade fever, pale clammy skin, changes in blood pressure, altered heart sounds.

Diagnosis of Myocardial Infarction (MI)

Confirmed through ECG readings and elevated troponin and creatine kinase levels.

Treatment Options for Myocardial Infarction (MI)

Thrombolytic therapy, anti-platelet medications, beta-blockers, percutaneous coronary intervention (PCTA), and coronary artery bypass grafting (CABG).

Prognosis After First Myocardial Infarction (MI)

23% may die before reaching the hospital.
13% die during hospitalization.
10% die within the first year post-discharge, with a continuous 5% risk annually thereafter.

Ischemic Stroke Diagnosis

Based on clinical signs and symptoms, confirmed through neuroimaging (CT/MRI) to differentiate stroke types.

Treatment Options for Ischemic Stroke

Thrombolytic therapy, anti-platelet therapies, and carotid endarterectomy.

Prognosis After Ischemic Stroke

Complete recovery occurs in about 10% of cases.
Significant long-term deficits are common, with an increased risk of subsequent strokes. Hospital mortality is 20%.

Causes of Venous Thrombosis

Risk factors include stasis (immobility), endothelial damage, and hypercoagulability contributing to Virchow's Triad.

Symptoms of Venous Thrombosis

Pain and tenderness in affected leg.
Swelling, redness, and warmth, typically unilateral.

Signs of Deep Vein Thrombosis (DVT)

Increased temperature, general malaise, elevated white blood cell count, and elevated erythrocyte sedimentation rate (ESR).

Diagnosis of Deep Vein Thrombosis (DVT)

Confirmed via ultrasound, venogram, and elevated D-dimer levels.

Treatment Options for Deep Vein Thrombosis (DVT)

Anti-coagulation therapy and thrombolytic treatment.

Prevention Measures for Deep Vein Thrombosis (DVT)

Encouraging leg exercises, using support stockings, and prescribing prophylactic anti-coagulation.

Prognosis of Deep Vein Thrombosis (DVT)

3% risk of fatal pulmonary embolism (PE).

Annual Incidence of Venous Thrombosis

Ranges from 1 to 3 cases per 1000 individuals.

Major Complications of Venous Thrombosis

Associated with post-thrombotic syndrome in 40% of cases and a 3% mortality rate.

Thrombophilia Overview

Refers to congenital or acquired conditions that increase the risk of venous thromboembolism.

Congenital Thrombophilia Causes

Include deficiencies in antithrombin, protein C, protein S, Factor V Leiden, Prothrombin G20210A, and Dysfibrinogenemia.

Acquired Thrombophilia Factors

Prior thrombosis, age, immobilization, surgery, malignancy, and hormonal therapies increase thrombotic risk.

General Impact of Hormone Therapy

Estrogen can increase clotting factor levels while decreasing levels of anti-thrombin III and protein S, heightening thrombosis risk.

Antiphospholipid Antibody Syndrome

Involves autoantibodies leading to increased risk of both arterial and venous thrombosis and associated with pregnancy complications.

Essential Thrombocytosis (Thrombocythemia)

Characterized by elevated platelet counts, risk of thrombosis or bleeding, classified as a myeloproliferative neoplasm.

Polycythemia Rubra Vera

Elevation of red blood cells leading to blood thickening, diagnosed by high hematocrit and hemoglobin levels.

Paroxysmal Nocturnal Hemoglobinuria (PNH)

Condition leading to RBC lysis, hemoglobinuria, and risks of venous thrombosis and bone marrow failure.

Summary of Thrombophilia Factors

Inherited thrombophilia syndromes (e.g., deficiencies in various coagulation factors) and acquired factors (e.g., past thrombosis, malignancy) contribute to thromboembolic risk.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on the steps involved in normal haemostasis following blood vessel injury. This quiz covers the physiological processes from collagen exposure to the formation of a stable clot. Understand how platelets adhere, activate, and aggregate in response to vascular injury.