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FIP > 14. Atherosclerosis > Flashcards

14. Atherosclerosis Flashcards

1
Q

What type of cell makes up the blood tissue interface?

A

Endothelial cells

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2
Q

What processes are regulated by endothelial cells?

A

Anticoagulation
Moderate vascular tone and blood flow
Regulate immune reactions
Bring lipoproteins into the cell wall to create atheroma

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3
Q

What is released by endothelial cells to regulate vascular tone?

A

NO

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4
Q

What is released by endothelial cells to regulate immune reactions?

A

Cytokines

Growth factors

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5
Q

What enzymes are expressed by endothelial cells?

A

LPL

ACE and ACE2

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6
Q

What is atherosclerosis?

A

Fibrofatty deposits accumulate in the intima of arteries

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7
Q

What arteries can be affected by atherosclerosis?

A

Elastic

Medium sized

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8
Q

What types of tissue gather in the intima of an artery in atherosclerosis?

A

Inflammatory
Immune
Smooth muscle
Connective tissue

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9
Q

What is the difference between arteriolar stenosis and atherosclerosis?

A

Arteriolar sclerosis is along the whole length of the arteriole
Atherosclerosis is found in focal points along elastic, muscular arteries

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10
Q

What is an atheroma?

A

Fibrolipid plaque that protrudes into the lumen

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11
Q

Describe the composition of an atheroma

A

Cholesterol lipid core

Fibrous cap

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12
Q

What are the consequences of atherosclerosis?

A

Infarction
Ischaemia
Embolus
Aneurysm

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13
Q

Describe the pathogenesis of atherosclerosis

A
  1. A chronic inflammatory response is initiated by the injury to the epithelium
  2. Accumulation of LDL in the vessel wall
  3. Invasion by monocytes and leukocytes which become macrophages
  4. Smooth muscle migrates from the media to the intima
  5. Macrophages are activated
  6. Macrophages and smooth muscle engulf lipid
  7. Smooth muscle, collagen and lipid accumulate to form a plaque
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14
Q

What features of a plaque make it stable?

A

Thick fibrous cap

Calcification

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15
Q

What are the risk factors for atherosclerosis?

A 
Age
Gender
Genetic abnormalities
Hyperlipidaemia
Hypertension
Smoking
Diabetes
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16
Q

What arteries can atheroma be found in?

A 
Abdominal aorta
Coronary
Popliteal
Descending thoracic aorta
Internal carotid and circle of willis
17
Q

What is an aneurysm?

A

Localised abnormal dilation in a blood vessel

18
Q

What is a true aneurysm?

A

Due to a weakened wall

19
Q

What is a false aneurysm?

A

External haematoma with connection to a leakign artery

20
Q

What are the causes of an aneursym?

A

Atherosclerosis
Congenital defects
infections
Trauma

21
Q

What is an outpouching aneurysm known as?

A

Saccular

22
Q

What is an aneurysm that extends the entire length of the vessel known as?

A

Fusiform

23
Q

What are the symptoms of an abdominal aortic aneurysm?

A

Severe abdominal pain
Shock
Pulsatile mass

24
Q

How is an abdominal aortic aneurysm diagnosed?

A

Ultrasound

25
Q

What are the consequences of an abdominal aortic aneursym?

A 
Rupture into peritoneal cavity
Obstruction to artery
Embolism from atheroma
Compress ureter
Erode vertebrae
26
Q

How is atherosclerosis managed?

A

Control of hypertension, diabetes, stop smoking
Reduce obesity
Exercise and diet
Statins to reduce hyperlipidaemia

27
Q

Thoracic aortic dissection is not related to atheroma. TF?

A

True

28
Q

What is a thoracic aortic dissection?

A

Tear in intima

Blood goes through tear and separates layers of the blood vessel wall

29
Q

What are the causes of thoracic aortic dissection?

A

Men aged 40-60
Hypertension
Connective tissue disorders
Complication of arterial cannulation

30
Q

What are the symptoms of thoracic aortic dissection?

A

Sudden onset of excruciating pain

Starts in anterior chest, radiates to back and downwards

31
Q

Why does atherosclerosis not happen in veins?

A

Veins don’t have high blood pressure

32
Q

Why does smoking increase the risk of atherosclerosis?

A

Vasoconstriction
Free radiacals
Affects platelet function
Increase circulating fibrinogen

33
Q

Why does diabetes increase the risk of atherosclerosis?

A

Increased risk of hyperlipidaemia
Impaired breakdown of LDL and fibrin due to glycosylation
High insulin

34
Q

What effect does dystrophic calcification have?

A

Hardens artery

35
Q

What effect does an intraplaque haemorrhage have?

A

Rapid enlargement of plaque

FIP (36 decks)

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