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13.01.24 Pathology teaching - Blood etc

Thrombus vs clot
  • Thrombus
    • Within a vessel
    • Contains platelets
  • Clot
    • Outside the circulation
    • No platelets


Virchow

  • Endothelial injury
    • Atheroma
    • Vasculitis
    • Trauma
  • Abnormal flow
    • Turbulence
    • Stasis
  • Hypercoagulability
    • Polycythaemia
    • Coagulopathy
      • Congenital
      • Acquired (pregnancy, cancer)


Atheroma outcomes

  • Occlusion/stenosis
  • Rupture
    • Occlusion
    • Embolus
  • Aneurysm
    • Rupture
    • Thromboembolus


Perforated viscus

  • Peptic ulcer
  • Appendix
  • Sigmoid colon
    • Diverticular disease
    • Tumour


Diverticular disease

  • Presents very similarly to CRC!
    • Bleeding
    • Obstruction
    • Change in bowel habits
    • Infection / abscess
    • Strictures


Complications of MI

  • Arrhythmias / Aneurysm
  • Bradycardia / ↓BP
  • Cardiac failure / cardiac tamponade
  • Dresslers / Death
  • Embolism / Extra (VSD, pap muscle rupture)

Notes

  • Plasminogen => Plasmin => Clot breakdown
  • Primary cause of clots
    • Atheroma in arteries, Clots in veins
  • Ischaemia is DYSFUNCTION due to reduced blood flow
  • Hartman's is an EMERGENCY procedure
    • Peritonism/rupture
    • No primary anastamosis
  • Ventricular aneurysms DON'T rupture
    • Cause thrombus instead
  • Danger time post-MI is 2-3 days
    • Myocytes are broken down but scar has not yet formed
    • => VSD, aneurysm
  • MI => Acute inflammation => Neutrophils
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