Given the history of the patient explain what contributed to the development of a deep venous thrombosis (DVT)
The patient’s DVT was caused by venous stasis, activation of the coagulation pathway, and vein damage. The patient was at risk of developing a thrombus due to being obese. The patient likely developed Venous stasis following vein damage during the total hip replacement. Immobility of the left leg following surgery and failure to attend physical therapy caused venous stasis contributing to DVT (Chindamo & Marques, 2019). The venous stasis caused an increased viscosity resulting in the formation of microthrombi, which are not cleared by fluid movement when there is high blood viscosity. This resulted in the formation of a blood clot from the microthrombi, which interrupted blood flow in the vein.
Scenario 5: COPD
A 66-year-old female with a 50 pack/year history of cigarette smoking had a CT scan and was diagnosed with emphysema. He asks if this means he has chronic obstructive pulmonary disease (COPD).
Question:
- There is a clear relationship between emphysema and COPD, explain the pathophysiology of emphysema and the relationship to COPD.
Emphysema is characterized by two significant changes: loss of lung elasticity and hyperinflation of the lung. It occurs when protein-degrading enzymes called proteases are at higher-than-normal levels. They damage the alveoli and the small airways by breaking down elastin (Rodrigues et al., 2021). High protease levels make the alveolar sacs lose their elasticity, and the small airways collapse or narrow. Some alveoli get destroyed, and others become large and flaccid with reduced area for effective gas exchange. An increased amount of air is trapped in the lungs due to loss of elastic recoil in the alveolar walls, overstretching and enlargement of the alveoli into air-filled spaces, and collapse of small airways (Rodrigues et al., 2021). Emphysema is linked to COPD since oxygenation is affected by the loss of alveolar tissue and the increased work of breathing. Usually, inhalation begins before exhalation is completed, causing an uncoordinated breathing pattern.
References
Chindamo, M. C., & Marques, M. A. (2019). Role of ambulation to prevent venous thromboembolism in medical patients: where do we stand?. Jornal Vascular Brasileiro, 18. https://doi.org/10.1590/1677-5449.180107
Dein, E., Douglas, H., Petri, M., Law, G., & Timlin, H. (2019). Pericarditis in Lupus. Cureus, 11(3), e4166. https://doi.org/10.7759/cureus.4166
Jebari-Benslaiman, S., Galicia-García, U., Larrea-Sebal, A., Olaetxea, J. R., Alloza, I., Vandenbroeck, K., Benito-Vicente, A., & Martín, C. (2022). Pathophysiology of Atherosclerosis. International journal of molecular sciences, 23(6), 3346. https://doi.org/10.3390/ijms23063346
Jomard, A., & Osto, E. (2020). High density lipoproteins: metabolism, function, and therapeutic potential. Front Cardiovasc Med. 2020; 7: 39. https://doi.org/10.3389/fcvm.2020.00039
Rodrigues, S. O., Cunha, C. M. C. D., Soares, G. M. V., Silva, P. L., Silva, A. R., & Gonçalves-de-Albuquerque, C. F. (2021). Mechanisms, Pathophysiology and Currently Proposed Treatments of Chronic Obstructive Pulmonary Disease. Pharmaceuticals (Basel, Switzerland), 14(10), 979. https://doi.org/10.3390/ph14100979
Wolf, D., & Ley, K. (2019). Immunity and inflammation in atherosclerosis. Circulation research, 124(2), 315-327.https://doi.org/10.1161/CIRCRESAHA.118.313591
