[17] Pathology of Ischemic Heart Diseases

Question 1

Common Sites of Atherosclerosis

Answer 1

Aorta

Coronary Arteries

Internal Carotid Arteries

Circle of Willis

Question 2

Plaque Components (6)

Answer 2

Smooth Muscle Cells

Connective Tissue

Matrix Macrophages

Basophils

T Lymphocytes

Lipid: Extracellular and Intracellular

SCM:BLT

Question 3

Mechanisms of Plaque Formation

Answer 3

1. LDL move freely in and out of intima
2. Small proportion of LDL undergoes minor modification and oxidative change
3. Modified LDL acts as an inflammatory stimulus and induces endothelial cells to produce adhesion molecule expression
4. Adhesion of circulating monocytes to intact endothelial cells and migration
5. Modified LDL taken up by macrophage scavengers and become foam cells
6. Macrophages are potent sources of smooth muscle cell growth factors

Question 4

Define:

Type II Atherosclerotic Lesion

Answer 4

Fatty Streak

Question 5

Define:

Type III Atherosclerotic Lesion

Answer 5

Lipid Foam Cell

Question 6

Define:

Type IV Atherosclerotic Lesion

Answer 6

W/ Lipid Core

W/ Fibrous Cap

Question 7

Define:

Type V Atheroscleroic Lesions
Va

Vb
Vc

Answer 7

Advanced, raised lesion

Va: Fibroatheroma

Vb: Calcified Lesion

Vc: Fibrotic Lesion

Question 8

Define:

Type VI Atherosclerotic Lesion

Answer 8

Complicated

Type IV or V with hemorrhages

Question 9

Define:

Endothelial Erosion

Answer 9

Areas of endothelial loss and intimal erosion over a plaque