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