2-Atherosclerosis

Question 1

a generic term for the hardening of arterioles and arteries

Answer 1

arteriosclerosis

Question 2

what are the clinical consequences for arteriosclerosis

Answer 2

none

Question 3

where is arteriosclerosis found mostly

Answer 3

kidneys and brain, not in extremities

Question 4

what is atherosclerosis

Answer 4

a subclassification of arteriosclerosis in which there are localized accumulations of lipid material within or beneath the intima of blood vessels

Question 5

what is the most frequent cause of morbidity caused by vascular disease

Answer 5

atherosclerosis

Question 6

what are the 3 patterns of vascular disease that have in common thickening and lost of elasticity of arterial wall

Answer 6

1-atherosclerosis (dominant)
2-Monckeberg arteriosclerosis
3-arteriosclerosis

Question 7

what is monckeberg arteriosclerosis

Answer 7

characterized by calcific deposits in medium sized muscluar arteries in persons older than 50 years

Question 8

the calcifications of monckeberg arteriosclerosis take what irregular form

Answer 8

irregular medial plates or discrete transverse rings

Question 9

what are the 2 anatomic variants of arteriosclerosis

Answer 9

1-hyaline arteriosclerosis

2-hyperplastic arteriosclerosis

Question 10

what is hyaline arteriosclerosis

Answer 10

muscle replaced by hyaline material in the media and intima

Question 11

what color is the homogenous material in a hyaline arteriosclerosis slide

Answer 11

pink-hematoxylin and eosin stain

Question 12

where is hyaline arteriosclerosis typically found

Answer 12

kidneys of patients with diabetes mellitus

Question 13

what is hyperplastic arteriosclerosis

Answer 13

thickening of arteriolar wall due to concentric proliferation of smooth muscle cells (onion skin appearance)

Question 14

what type of blood vessels are primarily affected by artherosclerosis

Answer 14

large elastic arteries and medium sized arteries

Question 15

what are the initial features of atherosclerosis

Answer 15

-deposits of lipids appearing as fatty streaks in the arterial wall

Question 16

during the atherosclerosis process these are lipid deposits form by small yellow patch like areas called what

Answer 16

plaque

Question 17

symptomatic atherosclerotic disease is localized where

Answer 17

arteries of heat and brain

Question 18

what is the major consequences of atherosclerosis

Answer 18

myocardial and cerebral infarction, aortic aneurysms

Question 19

what are some other consequences of atherosclerosis resulting from acutely or chronically diminished arterial perfusion

Answer 19

• gangrene of legs
• mesenteric occlusion
• cardiac arrest
• ischemic heart disease
• ischemic encephalopathy

Question 20

what is atheroma

Answer 20

plaque enlarges, and calcium deposits become admixed with accumulating lipids to form a mushy, gritty atheroslerotic plaque

Question 21

what is the hallmark lesion of atherosclerosis

Answer 21

atheroma

Question 22

how does a typical atheroma appear

Answer 22

as a hardening of the vessels wall

Question 23

what does the lipid-rich centers of atheroma consist of

Answer 23

primarily of cholesterol and cholesterol esters

Question 24

what is the composition of the fibrous cap (fibrotic capsule)

Answer 24

• proliferating smooth muscle cells
• macrophages
• lymphocytes
• foam cells
• EC matrix
• fibrin
• thrombus

Question 25

what are foam cells

Answer 25

in athersclerotic plaques, smooth muscle cells and macrophages within intima are filled with lipid vacuoles, made up of cholesterol and cholesterol esters

Question 26

what are the 3 components of atherosclerotic plaques

Answer 26

1-cells (smooth muscle, macrophages) 2-Conn tiss EC matrix--collogen, elastic fibers, proteoglycans 3-Intra and extracellular lipid deposits

Question 27

what are the 2 ways by which the process of atherosclerosis begins

Answer 27

1-fatty streaks | 2-intimal smooth muscle cell masses

Question 28

what is the evidence that fatty streaks and intimal smooth muscle masses evolve into atheromas

Answer 28

-evidence is indirect in that these progress into lesions that resemble atheromas

Question 29

how early in lifedo fatty streaks appear

Answer 29

can appear as early as one

Question 30

are all fatty streaks destined to become lesions

Answer 30

no

Question 31

what happens in advance atherosclerosis

Answer 31

fatty atheroma converted to fibrous scar

Question 32

which lesions of atherosclerosis have most clinical significance

Answer 32

``` 1-expansion of atheroma 2-fibrosis and calcification (calcify and become brittle) 3-ulceration and thrombosis 4-aneurysmatic dilation 5-hemorrhage ```