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PODT- Pathology > 11. Athersclerosis Ischaemia Infarction and Ischaemic Heart Disease > Flashcards

11. Athersclerosis Ischaemia Infarction and Ischaemic Heart Disease Flashcards

1
Q

Define atherosclerosis

A

Large and medium sized arteries -asymmetrical thickening

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2
Q

Discuss pathogenesis of atherosclerosis

A

Injury to edothelium leads to tissue response of vessel wall leading to an atheroma formation

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3
Q

Define arteriosclerosis

A

Thickening of small arteries or arterioles - symmetrical thickening

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4
Q

Explain the evolution of a plaque

A

Fatty streak causes atherosclerotic plaque
This will lead to a number of things including
Lumen narrowing
Atherothrombotic occlusion
Embolisation

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5
Q

List the risk factors for atherosclerosis/ischaemic heart disease

A

Family history, increasing age, male gender

Hyperlipidaemia, hypertension, obesity, smoking, diabetes melitus

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6
Q

What are the three types of atheromatous lesions?

A

Fatty streaks
Fibrolipid plaque
Complicated lesion

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7
Q

List the complications of atherosclerotic plaques

A

Acute arterial occlusion secondary to plaque rupture and thrombosis
Progressive luminal narrowing producing ischaemia of organ
Erosion media by plaque leading to aneurysm formation
Dislodgement of plaque thrombus or of plaque core constituents to produce emboli

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8
Q

What is blood supply of the lungs?

A

A dual pulmonary and bronchial artery blood supply

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9
Q

What is the blood supply of the liver?

A

Dual hepatic artery and portal vein circulation- relatively resistant to infarction

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10
Q

What is the renal and splenic blood supply?

A

In end artertial vascular obstruction it will usually lead to tissue death

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11
Q

What is the rate of the development of occlusion?

A

How fast the occlusion develops determines whether blood vessels can grow to by- pass the obstruction

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12
Q

What happens if the rate of development of occlusion is slow?

A

There is time to develop alternate perfusion pathways - collateral circulations

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13
Q

What are some of the consequences of atheroma?

A

Cerebral infarction
Myocardial infarction
Infarcted bowel

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14
Q

What are some of the symptoms of intermittent claudication

A 
Paraesthesia 
Pallor 
Pulselessness 
Paralysis 
Pokilothermia
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15
Q

What is ischaemic heart disease?

A

A spectrum of clinico-pathological entities including
-angina
-myocardial infarction
-sudden death
imbalance between demand for O2 and its supply by coronary arteries
Mainly due to atheroma and its complications but other factors such as vascular spasm and anaemia can contribute

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16
Q

What is the evolution of MI?

A 
Normal 
Necrosis
Inflammation 
Granulation 
SCAR
17
Q

What do the majority of acute MIs occur from?

A

Plaque rupture

18
Q

What are other causes of coronary thrombosis?

A

Erosion and calcified nodules

19
Q

What is meant by plaque rupture?

A

Fibrous cap disruption or fracture, with formation of an overlying thrombus

20
Q

What is plaque erosion?

A

Thrombus forms on eroded surface

21
Q

What are calcified nodules?

A

Characterised by eruptive dense calcified bodies protruding into the luminal space

22
Q

What is the gross and microscopic appearance of an MI after a few hours?

A

Gross - Normal

Microscopic- normal

23
Q

What is the gross and microscopic appearance of an MI after 1-3 days?

A

Gross- Pale/soft

Microscopic-Neutrophils

24
Q

What is the gross and microscopic appearance of an MI after 5-10 days?

A

Gross- Yellow centre with hyperaemic border

Microscopic - macrophages, granulation tissue

25
Q

What is the gross and microscopic appearance of an MI after several weeks?

A

Gross- white scar

Microscopic- Scar (collagen)

26
Q

What are MI complications?

A 
Death
Another MI
Rupture free wall ventricle/ventricular septum
Thrombus (mural)
Heart failre
Ventricular aneurysm
Arrhythmia/heart block
Dressler's syndrome (and other pericarditis)
Emboli 
Regurgutation

PODT- Pathology (15 decks)

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