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Thrombosis & Embolism Quiz

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What are the characteristic features of arterial thrombi?

They are pale, dry, and easily breakable, composed mainly of platelets and fibrin with little RBC, and are attached to the blood vessel wall.

What are the typical sites for venous thrombi to develop?

Deep calf veins, femoral veins, and iliac vein.

What is the primary component of arterial thrombi?

Platelets and fibrin.

What is the cause of edema of the ankle and foot in deep venous thrombosis?

Obstruction of blood flow due to the thrombus.

What is the purpose of Doppler ultrasound in the investigation of deep venous thrombosis?

To visualize blood flow and detect thrombi.

What is the most common source of emboli?

Dislodged thrombi.

What is the definition of embolism?

A detached intravascular solid, liquid, or gaseous mass carried by blood away from the point of origin.

What is the most common type of thromboembolism?

Pulmonary thromboembolism.

What is the fate of thrombi in terms of propagation?

Propagation can lead to the obstruction of the vessel.

What is the clinical finding in deep venous thrombosis when the ankle is dorsiflexed?

Calf pain.

What is thrombosis and what is it characterized by?

Thrombosis is the formation of a solid (clotted) mass of blood within a blood vessel, characterized by the formation of a thrombus.

What are some genetic predisposing factors for thrombosis?

Deficiency of Antithrombin, Protein C & S, and Fibrinolysis.

What is Virchow's triad, and what are the three main factors that predispose to thrombosis?

Virchow's triad are the three main factors that predispose to thrombosis: Endothelial injury, Alteration in blood flow, and Hypercoagulability of the blood.

What is endothelial injury, and what are some examples of it?

Endothelial injury is the injury to the endothelium, which exposes subendothelial collagen, leading to platelet and WBC activation, and initiation of the clotting mechanism. Examples include traumatic, inflammatory injury, hypertension, bacterial infection, autoimmune diseases, and smoking.

What is alteration in blood flow, and what are some examples of it?

Alteration in blood flow refers to changes in the normal blood flow pattern, such as turbulence and stasis. Examples include atherosclerosis, aneurysm, cardiac failure, long-term use of contraception, and severe burn or trauma.

What is hypercoagulability of the blood, and what are some factors that contribute to it?

Hypercoagulability of the blood refers to any alteration of the coagulation pathway that predisposes to thrombosis. Factors include increased coagulation factors, increased platelet count and adhesiveness, and decreased coagulation inhibitors such as Antithrombin III.

What is the microscopic picture of a thrombus?

The microscopic picture of a thrombus shows lines of Zahn, which are layers of the thrombus with different colors, with some layers richer in fibrin and RBCs, and others richer in platelets.

What is the difference between arterial and venous thrombosis?

Arterial thrombosis occurs in arteries, and is often caused by endothelial injury, whereas venous thrombosis occurs in veins, and is often caused by stasis or slowing of blood flow.

What is an aneurysm, and how does it relate to thrombosis?

An aneurysm is an abnormal dilation of an artery, which can lead to alteration in blood flow and increase the risk of thrombosis.

What is the relationship between smoking and thrombosis?

Smoking is a predisposing factor for thrombosis, as it can cause endothelial injury and increase the risk of thrombosis.

What is the primary component of a thrombus, and where is it formed?

The primary component of a thrombus is a solid (clotted) mass of blood, and it is formed within a blood vessel.

What are some acquired predisposing factors for thrombosis?

Old age, prolonged bed rest or immobilization, oral contraceptives, smoking, burns, and atherosclerosis are some acquired predisposing factors for thrombosis.

What is the role of platelets in thrombus formation?

Platelets come into contact with endothelial cells, which initiates the clotting mechanism to form a thrombus.

What is the significance of lines of Zahn in the microscopic picture of a thrombus?

Lines of Zahn indicate that thrombus formation occurred over time, with different layers of the thrombus being richer in fibrin and RBCs, or platelets, resulting in a layered appearance.

How does hypertension contribute to thrombosis?

Hypertension can cause endothelial injury, which exposes subendothelial collagen, leading to platelet activation and thrombus formation.

What is the relationship between atherosclerosis and thrombosis?

Atherosclerosis is a predisposing factor for thrombosis, as it can cause endothelial injury and alter blood flow, leading to thrombus formation.

What is the role of antithrombin III in the coagulation pathway?

Antithrombin III is a coagulation inhibitor that helps to prevent thrombosis by inhibiting the coagulation pathway.

How does cardiac failure contribute to thrombosis?

Cardiac failure can cause stasis, which is a slowing of blood flow, leading to thrombus formation.

What is the significance of Virchow's triad in thrombosis?

Virchow's triad consists of three main factors that predispose to thrombosis: endothelial injury, alteration in blood flow, and hypercoagulability of the blood.

How does smoking contribute to thrombosis?

Smoking can cause endothelial injury and increase platelet adhesiveness, leading to thrombus formation.

What is the main difference in composition between arterial and venous thrombi?

Arterial thrombi are composed mainly of platelets and fibrin with little RBC, whereas venous thrombi are composed of platelets, fibrin, and a large number of RBC.

What is the typical location where venous thrombi develop?

Deep calf veins, femoral veins, and iliac vein.

What is the clinical significance of edema of the ankle and foot in deep venous thrombosis?

It is a clinical finding in deep venous thrombosis, indicating obstruction of blood flow.

What is the primary fate of thrombi that can lead to obstruction of vessels?

Propagation.

What is the most common source of emboli, and what is the typical pathogenesis of pulmonary thromboembolism?

Deep veins thrombosis (DVT) of the lower extremities, and the thrombus dislodges and travels to the lungs, causing pulmonary thromboembolism.

What is the definition of embolism, and what are the common types of embolism?

A detached intravascular solid, liquid, or gaseous mass carried by blood away from the point of origin. Common types include pulmonary thromboembolism, systemic thromboembolism, fat embolism, air embolism, and amniotic fluid embolism.

What is the role of Doppler ultrasound in the investigation of deep venous thrombosis?

To diagnose and monitor deep venous thrombosis.

What is the relationship between slow blood flow in veins and the development of venous thrombi?

Slow blood flow in veins encourages the entrapment of red cells, leading to the development of venous thrombi.

What is the difference in appearance between arterial and venous thrombi?

Arterial thrombi are white (pale) and mural, whereas venous thrombi are red and occlusive.

What is the potential outcome of venous thrombosis, and what are the possible consequences?

Embolism, which can lead to infarction (ischemic necrosis) if the embolus lodges in a small vessel.

What is the primary component of a thrombus, and where is it formed?

A solid (clotted) mass of blood within a blood vessel (Thrombus).

What are the three main factors that predispose to thrombosis according to Virchow's triad?

Endothelial injury, alteration in blood flow, and hypercoagulability of the blood.

What is the significance of lines of Zahn in the microscopic picture of a thrombus?

Lines of Zahn show that thrombus formation occurred over time, with layers of fibrin and RBCs, and others with platelets.

What is the relationship between atherosclerosis and thrombosis?

Atherosclerosis is an acquired predisposing factor for thrombosis.

How does cardiac failure contribute to thrombosis?

Cardiac failure can lead to stasis, which is an alteration in blood flow that predisposes to thrombosis.

What is the role of antithrombin III in the coagulation pathway?

Antithrombin III is a coagulation inhibitor that prevents excessive thrombus formation.

What is the primary fate of thrombi that can lead to obstruction of vessels?

Propagation.

What is the most common source of emboli, and what is the typical pathogenesis of pulmonary thromboembolism?

The most common source of emboli is deep venous thrombosis, which can lead to pulmonary thromboembolism.

What is the definition of embolism, and what are the common types of embolism?

Embolism is the obstruction of a blood vessel by a blood clot or other material, and common types include thromboembolism, fat embolism, and air embolism.

What is the significance of endothelial injury in thrombosis?

Endothelial injury exposes subendothelial collagen, which initiates the clotting mechanism and can lead to thrombus formation.

What are the main differences between arterial and venous thrombi in terms of composition and location?

Arterial thrombi are composed mainly of platelets and fibrin with little RBC, whereas venous thrombi are composed of platelets, fibrin, and a large number of RBC. Arterial thrombi are attached to the blood vessel wall, whereas venous thrombi typically develop in the venous system.

What are the common clinical findings in deep venous thrombosis?

The common clinical findings in deep venous thrombosis include edema of the ankle and foot, and calf pain when the ankle is dorsiflexed.

What is the primary fate of thrombi that can lead to serious consequences?

The primary fate of thrombi that can lead to serious consequences is propagation, which can lead to obstruction of vessels and ultimately infarction or ischemic necrosis.

What is the role of slow blood flow in veins in the development of venous thrombi?

Slow blood flow in veins encourages the entrapment of red cells, which contributes to the development of venous thrombi.

What is the purpose of Doppler ultrasound in the investigation of deep venous thrombosis?

Doppler ultrasound is used to investigate deep venous thrombosis by detecting blood flow and identifying any abnormalities or obstruction.

What is the most common type of embolism, and what is its typical pathogenesis?

The most common type of embolism is pulmonary thromboembolism, which typically originates from dislodged thrombi in the deep veins of the lower extremities.

What is the relationship between atherosclerosis and thrombosis?

Atherosclerosis can contribute to thrombosis by narrowing the lumen of the vessel, creating a site for thrombus formation.

What are the common types of embolism?

The common types of embolism include pulmonary thromboembolism, systemic thromboembolism, fat embolism, air embolism, and amniotic fluid embolism.

What is the significance of edema of the ankle and foot in deep venous thrombosis?

Edema of the ankle and foot is a clinical finding in deep venous thrombosis, indicating venous obstruction and potential serious consequences.

What is the role of platelets in thrombus formation?

Platelets play a crucial role in thrombus formation by aggregating and forming a platelet plug, which is then stabilized by fibrin.

What is the primary component of a thrombus?

A solid (clotted) mass of blood

What is the role of platelets in thrombus formation?

Platelets come in contact with endothelial cells, initiating the clotting mechanism to form a thrombus

How does hypertension contribute to thrombosis?

Hypertension can cause endothelial injury, leading to thrombosis

What is the significance of Virchow's triad in thrombosis?

Virchow's triad identifies three main factors that predispose to thrombosis: endothelial injury, alteration in blood flow, and hypercoagulability of the blood

What is the difference between arterial and venous thrombosis?

Arterial thrombosis is characterized by a thrombus formed in an artery, while venous thrombosis is characterized by a thrombus formed in a vein

What is the relationship between atherosclerosis and thrombosis?

Atherosclerosis can lead to endothelial injury, increasing the risk of thrombosis

How does cardiac failure contribute to thrombosis?

Cardiac failure can lead to stasis, increasing the risk of thrombosis

What is the role of antithrombin III in the coagulation pathway?

Antithrombin III is a coagulation inhibitor that prevents thrombosis

What is the primary fate of thrombi that can lead to obstruction of vessels?

Propagation of the thrombus

What is the significance of lines of Zahn in the microscopic picture of a thrombus?

Lines of Zahn show the different layers of the thrombus, which are richer in fibrin and RBCs in some areas and richer in platelets in others

What is the main reason why venous thrombi are more likely to develop in the deep calf veins and femoral veins?

Slow blood flow in veins encourages entrapment of red cells.

What is the primary fate of thrombi that can lead to infarction (ischemic necrosis)?

Embolism

What is the difference in composition between arterial and venous thrombi?

Arterial thrombi are composed mainly of platelets and fibrin with little RBC, while venous thrombi are composed of platelets, fibrin, and a large number of RBC.

What is the purpose of Doppler Ultrasound in the investigation of deep venous thrombosis?

To diagnose deep venous thrombosis

What is the clinical significance of edema of the ankle and foot in deep venous thrombosis?

It is a sign of deep venous thrombosis

What is the potential outcome of venous thrombosis if left untreated?

Embolism, which can lead to infarction (ischemic necrosis)

What is the relationship between atherosclerosis and thrombosis?

Atherosclerosis can contribute to the development of thrombosis by causing endothelial injury and narrowing of the vessel lumen.

What is the role of platelets in thrombus formation?

Platelets are a main component of thrombi, and they play a key role in the formation of thrombi.

What is the significance of Virchow's triad in thrombosis?

Virchow's triad identifies the three main factors that predispose to thrombosis: endothelial injury, alteration in blood flow, and hypercoagulability of the blood.

What is the difference in appearance between arterial and venous thrombi?

Arterial thrombi are white and pale, while venous thrombi are red and occlusive.

Study Notes

Thrombosis

  • Formation of a solid (clotted) mass of blood within a blood vessel, resulting in a thrombus
  • Predisposing factors:
    • Genetic: deficiency of antithrombin, protein C & S, and fibrinolysis
    • Acquired: old age, prolonged bed rest or immobilization, oral contraceptives, smoking, burns, atherosclerosis, and varicose veins
  • Microscopic picture:
    • Virchow's triad: endothelial injury, alteration in blood flow, and hypercoagulability of the blood
    • Endothelial injury: exposure of subendothelial collagen, platelet and WBC aggregation, and initiation of clotting mechanism
    • Alteration in blood flow: turbulence (arterial) and stasis (venous)
    • Hypercoagulability of the blood: increased coagulation factors, platelet count and adhesiveness, and decreased coagulation inhibitors
  • Microscopic picture of thrombus:
    • Lines of Zahn: thrombus formation over time, with alternating layers of fibrin, RBCs, and platelets
    • Morphological types: arterial (white, pale, and mural) and venous (red and occlusive) thrombi
    • Arterial thrombi: composed of platelets, fibrin, and few RBCs, attached to blood vessel wall
    • Venous thrombi: composed of platelets, fibrin, and many RBCs, typically develop in venous system

Embolism

  • Definition: a detached intravascular solid, liquid, or gaseous mass carried by blood away from the point of origin
  • Pathogenesis: 99% of emboli are from dislodged thrombi (thromboembolus)
  • Causes:
    • 90%: deep veins thrombosis (DVT) of lower extremities
    • Others: pelvic venous plexus, right side of heart
  • Types:
    • Pulmonary thromboembolism
    • Systemic thromboembolism
    • Fat embolism
    • Air embolism
    • Amniotic fluid embolism
  • Pulmonary embolism: a detached thrombus that lodges in the lungs, causing complete or partial occlusion and resulting in infarction (ischemic necrosis)

Thrombosis

  • Formation of a solid (clotted) mass of blood within a blood vessel, resulting in a thrombus
  • Predisposing factors:
    • Genetic: deficiency of antithrombin, protein C & S, and fibrinolysis
    • Acquired: old age, prolonged bed rest or immobilization, oral contraceptives, smoking, burns, atherosclerosis, and varicose veins
  • Microscopic picture:
    • Virchow's triad: endothelial injury, alteration in blood flow, and hypercoagulability of the blood
    • Endothelial injury: exposure of subendothelial collagen, platelet and WBC aggregation, and initiation of clotting mechanism
    • Alteration in blood flow: turbulence (arterial) and stasis (venous)
    • Hypercoagulability of the blood: increased coagulation factors, platelet count and adhesiveness, and decreased coagulation inhibitors
  • Microscopic picture of thrombus:
    • Lines of Zahn: thrombus formation over time, with alternating layers of fibrin, RBCs, and platelets
    • Morphological types: arterial (white, pale, and mural) and venous (red and occlusive) thrombi
    • Arterial thrombi: composed of platelets, fibrin, and few RBCs, attached to blood vessel wall
    • Venous thrombi: composed of platelets, fibrin, and many RBCs, typically develop in venous system

Embolism

  • Definition: a detached intravascular solid, liquid, or gaseous mass carried by blood away from the point of origin
  • Pathogenesis: 99% of emboli are from dislodged thrombi (thromboembolus)
  • Causes:
    • 90%: deep veins thrombosis (DVT) of lower extremities
    • Others: pelvic venous plexus, right side of heart
  • Types:
    • Pulmonary thromboembolism
    • Systemic thromboembolism
    • Fat embolism
    • Air embolism
    • Amniotic fluid embolism
  • Pulmonary embolism: a detached thrombus that lodges in the lungs, causing complete or partial occlusion and resulting in infarction (ischemic necrosis)

Thrombosis

  • Formation of a solid (clotted) mass of blood within a blood vessel, resulting in a thrombus
  • Predisposing factors:
    • Genetic: deficiency of antithrombin, protein C & S, and fibrinolysis
    • Acquired: old age, prolonged bed rest or immobilization, oral contraceptives, smoking, burns, atherosclerosis, and varicose veins
  • Microscopic picture:
    • Virchow's triad: endothelial injury, alteration in blood flow, and hypercoagulability of the blood
    • Endothelial injury: exposure of subendothelial collagen, platelet and WBC aggregation, and initiation of clotting mechanism
    • Alteration in blood flow: turbulence (arterial) and stasis (venous)
    • Hypercoagulability of the blood: increased coagulation factors, platelet count and adhesiveness, and decreased coagulation inhibitors
  • Microscopic picture of thrombus:
    • Lines of Zahn: thrombus formation over time, with alternating layers of fibrin, RBCs, and platelets
    • Morphological types: arterial (white, pale, and mural) and venous (red and occlusive) thrombi
    • Arterial thrombi: composed of platelets, fibrin, and few RBCs, attached to blood vessel wall
    • Venous thrombi: composed of platelets, fibrin, and many RBCs, typically develop in venous system

Embolism

  • Definition: a detached intravascular solid, liquid, or gaseous mass carried by blood away from the point of origin
  • Pathogenesis: 99% of emboli are from dislodged thrombi (thromboembolus)
  • Causes:
    • 90%: deep veins thrombosis (DVT) of lower extremities
    • Others: pelvic venous plexus, right side of heart
  • Types:
    • Pulmonary thromboembolism
    • Systemic thromboembolism
    • Fat embolism
    • Air embolism
    • Amniotic fluid embolism
  • Pulmonary embolism: a detached thrombus that lodges in the lungs, causing complete or partial occlusion and resulting in infarction (ischemic necrosis)

Thrombosis

  • Formation of a solid (clotted) mass of blood within a blood vessel, resulting in a thrombus
  • Predisposing factors:
    • Genetic: deficiency of antithrombin, protein C & S, and fibrinolysis
    • Acquired: old age, prolonged bed rest or immobilization, oral contraceptives, smoking, burns, atherosclerosis, and varicose veins
  • Microscopic picture:
    • Virchow's triad: endothelial injury, alteration in blood flow, and hypercoagulability of the blood
    • Endothelial injury: exposure of subendothelial collagen, platelet and WBC aggregation, and initiation of clotting mechanism
    • Alteration in blood flow: turbulence (arterial) and stasis (venous)
    • Hypercoagulability of the blood: increased coagulation factors, platelet count and adhesiveness, and decreased coagulation inhibitors
  • Microscopic picture of thrombus:
    • Lines of Zahn: thrombus formation over time, with alternating layers of fibrin, RBCs, and platelets
    • Morphological types: arterial (white, pale, and mural) and venous (red and occlusive) thrombi
    • Arterial thrombi: composed of platelets, fibrin, and few RBCs, attached to blood vessel wall
    • Venous thrombi: composed of platelets, fibrin, and many RBCs, typically develop in venous system

Embolism

  • Definition: a detached intravascular solid, liquid, or gaseous mass carried by blood away from the point of origin
  • Pathogenesis: 99% of emboli are from dislodged thrombi (thromboembolus)
  • Causes:
    • 90%: deep veins thrombosis (DVT) of lower extremities
    • Others: pelvic venous plexus, right side of heart
  • Types:
    • Pulmonary thromboembolism
    • Systemic thromboembolism
    • Fat embolism
    • Air embolism
    • Amniotic fluid embolism
  • Pulmonary embolism: a detached thrombus that lodges in the lungs, causing complete or partial occlusion and resulting in infarction (ischemic necrosis)

Test your knowledge of thrombosis and embolism, including definitions, causes, types, and microscopic pictures. Learn about predisposing factors, genetic and acquired, and more!

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