Questions and Answers
What is the first step in the process of normal haemostasis following injury to a blood vessel?
Which physiological process follows collagen exposure during normal haemostasis?
What primarily causes arterial thrombosis?
What occurs during the coagulation process related to thrombus formation?
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Which condition is a consequence of venous thrombosis?
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What symptom is commonly associated with peripheral arterial disease (PAD)?
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What is a recognized sign of ischaemic stroke resulting from arterial thrombosis?
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Which of the following is NOT a step in normal haemostasis?
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What is one common diagnostic method used to confirm deep vein thrombosis (DVT)?
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What is a common prevention measure for deep vein thrombosis (DVT)?
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Which condition is commonly associated with an increased risk of developing thrombophilia?
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What is the risk of fatal pulmonary embolism (PE) associated with deep vein thrombosis (DVT)?
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What is the inheritance pattern for Anti-thrombin III Deficiency?
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What symptom is commonly associated with arterial thrombosis in the case of a myocardial infarction (MI)?
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What is the increased risk of venous thrombosis (VT) for individuals with Protein C Deficiency?
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Which diagnostic method is NOT typically used to confirm arterial thrombosis in myocardial infarction (MI)?
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In which condition is the level of Protein S known to drop?
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What treatment option is least appropriate for myocardial infarction related to arterial thrombosis?
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What percentage of individuals with Anti-thrombin III Deficiency are likely to develop a clot in their lifetime?
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What is the prevalence of Protein S Deficiency in the population?
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Which sign is NOT indicative of an ischemic stroke?
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What is a common prognosis related to an ischemic stroke?
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What major complication occurs in 40% of cases associated with venous thrombosis?
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Which component is NOT part of Virchow's Triad contributing to venous thrombosis?
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Which symptom is specific to deep vein thrombosis (DVT)?
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Emboli from venous thrombi typically travel to which location?
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What is a major risk factor for the development of deep vein thrombosis (DVT)?
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What percentage of individuals die before reaching a hospital after a first myocardial infarction (MI)?
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What conditions are associated with decreased levels of Protein S?
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What is the consequence of estrogen therapy on tissue plasminogen activator (tPA) levels?
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What caution should be observed before initiating estrogen therapy?
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Which of the following is not a name used for Antiphospholipid Antibody Syndrome?
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What percentage of healthy individuals are known to have antiphospholipid antibodies?
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Which complication is associated with Antiphospholipid Antibody Syndrome in vivo?
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What condition is characterized by a raised platelet count above 150-400 x 10^9/L?
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What is the primary defect in Paroxysmal Nocturnal Hemoglobinuria (PNH)?
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Which of the following is not classified as a myeloproliferative neoplasm?
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What effect does Paroxysmal Nocturnal Hemoglobinuria have on urine color in the morning?
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What is the increased risk of venous thrombosis (VT) for heterozygotes of Factor V Leiden?
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In which circumstance is activated protein C resistance (APCR) less likely to occur?
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How does the Prothrombin G20210A allele affect prothrombin levels?
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What is the inheritance pattern of Dysfibrinogenemia?
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Which acquired risk factor increases the risk of thrombosis due to age-related changes?
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What is the strongest risk factor for acquired thrombophilia?
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How does estrogen therapy specifically affect levels of protein S?
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Which demographic groups are most prone to acquired thrombophilia?
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Which of the following conditions is associated with compression of the left common iliac vein?
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How does malignancy contribute to the risk of acquired thrombophilia?
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Study Notes
Normal Haemostasis Stages
- Injury to blood vessel exposes collagen, initiating haemostasis.
- Platelet adhesion occurs as platelets bind to exposed collagen.
- Platelet activation follows, triggering a cascade of responses.
- Activated platelets secrete substances to recruit more platelets.
- Platelet aggregation leads to the formation of a platelet plug.
- Fibrin strands form to trap cells, creating a stable clot or thrombus.
- Coagulation occurs, solidifying the clot structure.
Arterial Thrombosis
- Major causes include inappropriate platelet activation due to:
- Atherosclerosis and plaque rupture exposing thrombogenic lipids.
- Often results in conditions such as:
- Myocardial Infarction (MI)
- Ischaemic Stroke
- Peripheral Arterial Disease (PAD)
- Symptoms for each include:
- Ischaemic Stroke: Sudden weakness, numbness, trouble speaking, and confusion.
- PAD: Leg pain or cramping during activity, sores that don't heal.
- MI: Chest pain radiating to arms/neck, shortness of breath, nausea, and sweating.
Diagnosis and Prognosis of MI
- Diagnosed with ECG, elevated troponin, and creatine kinase levels.
- Prognosis shows high mortality rates:
- 23% die before reaching the hospital,
- 13% during hospital admission,
- 10% within the first year after discharge.
Venous Thrombosis
- Common causes include:
- Immobility (e.g., bed rest, long flights)
- Prolonged postoperative recovery
- Symptoms include leg pain, swelling, redness, and heat.
- Embolisms typically travel to lungs causing pulmonary embolism (PE).
Diagnosis and Treatment of DVT
- Diagnosis via ultrasound, venogram, and elevated D-dimers.
- Treatment involves anticoagulation and thrombolytic therapy.
- Prevention methods include physical activity and support stockings.
Thrombophilia Overview
- Increased long-term risk of venous thromboembolism (VTE).
- Can be inherited (e.g., Antithrombin deficiency) or acquired (e.g., immobilization).
- Virchow's Triad components: Stasis, Endothelial damage, Hypercoagulability.
Inherited Disorders in Thrombophilia
- Antithrombin III Deficiency: Autosomal dominant, high clot risk (50% lifetime).
- Protein C Deficiency: Autosomal variation, 10-15 times increased risk of VT.
- Protein S Deficiency: Variability in function, 10 times increased risk of VT.
Risk Factors and Conditions
- Factor V Leiden: Increased risk for homozygotes (80 times).
- Prothrombin G20210A allele: Elevated prothrombin levels, 2-3 times increased risk.
- Essential Thrombocytosis: Elevated platelet counts leading to bleeding or thrombosis.
Acquired Thrombophilia Drivers
- Previous thrombosis increases risk by 5 times; older adults and obese individuals are more affected.
- Major surgeries elevate risk due to stasis and activity reduction.
- Hormonal factors (e.g., oral contraceptives) increase clotting factor levels and risk.
Specific Conditions
- Antiphospholipid Antibody Syndrome: Linked to increased arterial and venous thrombosis.
- Paroxysmal Nocturnal Hemoglobinuria: Lysis of RBCs with lifelong risk of thrombotic events.
- Myeloproliferative Neoplasms: Includes Polycythemia Vera with increased RBC production.
Summary on Thrombophilia
- Inherited Factors: Antithrombin, Protein C, Protein S deficiencies, Factor V Leiden, and more.
- Acquired Factors: Age, immobilization, surgery, malignancy, and hormonal therapies continue to increase VTE risk.
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Description
Explore the intricate steps of normal haemostasis following blood vessel injury. This quiz covers the sequence from collagen exposure to the formation of a stable clot, highlighting the roles of platelets and coagulation in the process.