Medicine and surgery notes

Apr 24th, 2015
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THROMBOTIC DISORDERS Oclussion of blood vessel by platelet plug orfibrin clot may occurin vessel of any size. Capillary & small vessel: inVasculitic dsesDICMedium sized vessel: inCyanotic CHDHomocystinuriaDehydrationPolyarteitis nodosaCont.. Larger vessels: inAortic thrombosisSVC thrombosisDVTSC AnaemiaPulmonary EmbolismPATHOGENESIS Vessel injury in addition to;Abnormal platele adhessivenessaggregationAn activated coagulation mechanismAn inactive inhibitor systemAn inactive fibrinolytic mechanismReduced blood flow.Cont..a)b)c)d)Formation of clot is regulated by acomplex inhibitor system involving:Antithrombin IIIProtein CA co-factor for activated protein C(probably factor V)Protein SCont.. They prevent;a) Spontaneous intravascular coagulationb) Limit thrombotic response of body toinjury.c) Control extension of existing clotsReduced plasma levels leads to propensityto excessive thrombosisCont.. Thromboembolic dses in deficient ptspredominantly affect the venous system.-Arterial forms are rare. Manifestations:DVT of legs,pulmonary embolism,thrombosis of pelvic veins,sagittal sinus thrombosis 1 st thrombolitic event usually occurs from 1025 yrsCAUSES A) Congenital and Inherited defectsCongenital hypoplasmonogenemia anddysplasminogenemia reduced ability to remove fibrinclots Plasminogen abnormalitiesCongenital dysfibrinogenemia format

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