26 Atherosclerosis Flashcards

1
Q

T/F large arteries and medium arteries are all >2mm in diameter?

A

True for this lecture

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2
Q

which vessels (size) are within the range of 2mm and 100um?

A

small arteries

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3
Q

which vessels (size) are within the range of 100-20um?

A

arterioles

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4
Q

The tunica media of large and medium sized vessels is characterized by? small arteries? arterioles?

A

1) multiple layers of smooth m.
2) a few layers of smooth m.
3) 1-2 layers of smooth m.

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5
Q

what is the difference between atherosclerosis and arteriosclerosis?

A

Atherosclerosis is a form of arteriosclerosis. Arteriosclerosis is a generic term for thickening and loss of elasticity of the arterial walls. (hardening of the arteries) that affects the LARGE and MEDIUM arteries.

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6
Q

What are the 3 forms of arteriosclerosis?

A

1) atherosclerosis
2) monckeberg medial calcific sclerosis
3) arteriolosclerosis

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7
Q

what is arteriolosclerosis?

A

a form of cardiovascular disease affecting the small arteries and arterioles.

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8
Q

what is monckeberg medial calcific sclerosis?

A

deposits of calcium in the muscular arteries which do not encroach the lumen.

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9
Q

T/F atherosclerosis is the leading cause of cardiovascular disease?

A

true (nearly 75%)

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10
Q

what percentage of TOTAL deaths in the US is due to atherosclerosis?

A

30%

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11
Q

T/F CVD has been the #1 killer in the USA every year since 1900?

A

Almost true. (The only exception was in 1918 because of the pandemic flu)

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12
Q

what is considered the most important modifiable risk factor for atherosclerosis?

A

Hyperlipidemia

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13
Q

what are considered the four major modifiable (you are able to do something about them) risk factors for atherosclerosis?

A

1) hyperlipidemia
2) hypertension
3) smoking
4) diabetes

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14
Q

what are considered the four major non-modifiable (you are not able to do something about them) risk factors for atherosclerosis?

A

1) increasing age
2) male gender
3) family history
4) genetics

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15
Q

T/F Men are always at a higher risk for CHD?

A

true. (this is opposed to hypertension where women become more prone to hypertension after menopause.)

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16
Q

where do atherosclerotic plaques form (layer)?

A

The tunica intima

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17
Q

what are the 4 stages of plaque formation?

A

1) endothelial dysfunction
2) fatty streak formation
3) plaque growth and maturation
4) unstable fibrous plaque

18
Q

what causes increased permeability to circulating lipids and emigration of monocytes?

A

endothelial damage

19
Q

what causes the fatty streak?

A

accumulation of lipids and moncytes in the arterial intima

20
Q

what is the earliest stage at which the developing atherosclerotic plaque can be recognized at the gross and microscopic level?

A

the fatty streak formation stage

21
Q

what does oil red stain do the the lumen of a vessel?

A

allows you to see fatty streakes

22
Q

The maturation process of a plaque is best exemplified by?

A

formation of the fibrous cap which is composed mainly of smooth muscle cells that have migrated from the tunica media.

23
Q

what does cholesterol look like within an atherosclerotic plaque?

A

crystals

24
Q

T/F Large atherosclerotic plaques become vascularized?

A

true

25
Q

what happens when an atherosclerotic plaque ruptures?

A

it triggers clot formation at the surface of plaque causing it to worsen.

26
Q

T/F T lymphocytes have a role in atherosclerosis?

A

true. (there is also a lot of inflammation involved)

27
Q

what is thought to be the #1 cause of endothelial dysfunction?

A

shear stress

28
Q

what is thought to be the #1 cause of fatty streak formation?

A

macrophages engulfing oxidized lipids

29
Q

what is the reason behind plaque growth and maturation?

A

chronic inflammation and growth factors

30
Q

what is the reason why atherosclerotic plaques become unstable?

A

angiogenesis, unstable fibrous plaque, and apoptosis

31
Q

what 3 areas (arteries) are most affected by atherosclerosis?

A

1) aorta
2) coronary arteries
3) carotids

32
Q

what are the 3 major consequences of chronic atherosclerosis?

A

1) myocardial infarction
2) cerebral infaction (stroke)
3) aortic aneurysm

33
Q

T/F arterial branch points are particularly susceptable to the formation of atherosclerotic plaques?

A

true

34
Q

T/F an aneurysm is an abnormal dilitation of wall of the heart?

A

True as well as any vessel

35
Q

what is the difference between a true aneurysm and a false aneurysm?

A

True involves all layers of the wall

False involves ruptured layers with a hematoma

36
Q

what is the most common cause of aortic aneurysms? Second most common?

A

1) atherosclerosis

2) cystic medial degeneration (marfans)

37
Q

What are 3 other less common causes of aotic aneurysms?

A

1) tertiary syphilis
2) infections
3) trauma

38
Q

where is the most common area for the formation of an aortic aneurysm?

A

abdominal aorta

39
Q

T/F males over 50 who smoke are most likely to have an abdominal aortic aneurism?

A

True (3 of the most common factors)

40
Q

if you have an aortic aneurysm that is under 4 cm, what is the chance that it will rupture each year? over 5 cm?

A

under 4cm = 2%

over 5cm = 10%

41
Q

what are the chances you will die from repair of an aortic aneurism that is not ruptured? ruptured?

A

not ruptured = 5%

ruptured = 50%