αθηροσκληρυνση

Question 1

A 65-year-old man has diabetes and hypertension. What disease process do you suspect in his small arteries and arterioles?

Answer 1

Hyaline arteriolosclerosis (thickening of the small artery vessel walls in essential hypertension or diabetes mellitus

Question 2

What is another name for Mönckeberg arteriosclerosis?

Answer 2

Medial calcific sclerosis

Question 3

What is atherosclerosis? Which types of arteries are susceptible to atherosclerosis?

Answer 3

It is a form of arteriosclerosis caused by cholesterol plaque buildup; elastic arteries as well as large- and medium-sized muscular arteries

Question 4

A 75-year-old woman has a long history of hypertension and has developed atherosclerosis. Name six possible complications of this disease.

Answer 4

Aneurysms, ischemia, infarcts, peripheral vascular disease, thrombus, emboli

Question 5

What are two symptoms of ischemia resulting from atherosclerosis?

Answer 5

Angina and claudication, although many patients may be asymptomatic

Question 6

Name four modifiable and three nonmodifiable risk factors for atherosclerosis.

Answer 6

Modifiable=smoking, hypertension, diabetes mellitus, hyperlipidemia (nonmodifiable=age, gender [men/postmenopausal women], family history)

Question 7

List the four most common locations for atherosclerosis to occur in order of prevalence.

Answer 7

Abdominal aorta, coronary artery, popliteal artery, and carotid artery

Question 8

Fatty streaks are a precursor for atherosclerotic plaques. How are fatty streaks formed?

Answer 8

Endothelial cell dysfunction with macrophage and LDL accumulation leads to foam cell formation, which then forms fatty streaks

Question 9

In addition to hypertension and connective tissue disease (e.g., Marfan syndrome), what conditions are linked with thoracic aortic aneurysm?

Answer 9

Cystic medial degeneration, bicuspid aortic valve, 3° syphilis (obliterative endarteritis of vasa vasorum)

Question 10

A patient has a localized, pathologic dilatation of the aorta. What symptoms exhibited by this patient will require immediate attention ?

Answer 10

Symptoms of back and/or abdominal pain indicate leaking, dissection, or imminent rupture (the patient has an aortic aneurysm)

Question 11

A very tall and flexible 25-year-old man presents for an annual exam. He is from a tall family. What vascular lesion is he most at risk for?

Answer 11

Aortic dissection, because he likely has Marfan syndrome—it is also associated with hypertension and a bicuspid aortic valve

Question 12

Define the two types of aortic dissection: Stanford type A and Stanford type B.

Answer 12

A = proximal, involves ascending aorta, may extend to aortic arch/descending aorta, B = distal, involves aortic arch and/or descending aorta

Question 13

A patient is found to have an aortic dissection that is located only at the descending aorta. What is the treatment for his condition?

Answer 13

Treat medically with β-blockers, then vasodilators (this is Stanford type B aortic dissection)

Question 14

A patient is found to have an aortic dissection that is located only at the ascending aorta. What is the treatment for his condition?

Answer 14

Treatment is surgery (the patient has Stanford type A aortic dissection)