Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathological Processes > 6. Atherosclerosis > Flashcards

6. Atherosclerosis Flashcards

1
Q

What is arteriosclerosis?

A

Arteriosclerosis = hardening of the arteries. In this condition the walls of arteries are thickened and lose their elasticity. It includes atherosclerosis, arteriolosclerosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is atherosclerosis?

A

The accumulation of intracellular and extracellular lipid in the intima and media of large and medium sized arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a fatty streak?

A

Lipid deposits in the intima, is not raised and does not effect blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the macroscopic appearance of a fatty streak?

A

yellow, slightly raised area - does not impede blood flow, not raised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the macroscopic appearance of a simple plaque?

A

Raised yellow/white area with an irregular outline, enlarge and coalesce

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What happens in a compliated plaque?

A

calcification, thrombosis, aneurysm formation, haemorrhage and expansion of plaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What blood vessels does atherosclerosis affect?

A

Arteries only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does athersclerosis lead to death?

A

Leads to stenosis of the arterial lumen and can result in myocardial infarction and stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the common sites for atherosclerosis?

A

Elastic arteries- aorta, carotid and iliac arteries
Large and medium sized muscular arteries-coronary and popliteal arteries
Commoner in the abdominal rather than the thoracic aorta.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is arteriolosclerosis?

A

Hardening of the arterioles - usually due to hypertension and diabetes mellitus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is an atheroma?

A

Atheroma is the necrotic core of the atherosclerotic plaque. It consists of dead cells, debris and cholesterol crystals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 3 basic components of a plaque?

A
  • Cells – macrophages, leucocytes, smooth muscle cells
  • Intra- and extracellular lipid
  • Extracellular matrix – collagen, elastin, proteoglycans.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the microscopic appearance of a fatty streak?

A

Intimal foam cells, some smooth muscle cells and some extracellular lipid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the microscopic appearance of a plaque?

A

fibrosis, necrosis, cholesterol clefts, disruption of the internal elastic lamina, extension into the media and ingrowth of small vessels from the adventitia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is an aneurysm?

A

local dilatations of an artery due to weakening of the arterial wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the effects of severe atherosclerosis in the coronary arteries?

A

myocardial infarction, chronic ischaemic heart disease, arrhythmias, cardiac failure and sudden cardiac death,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the effects of severe atherosclerosis in cerebral arteries?

A

Cerebeal ischaemia -
Cerebral infarction (stroke)
Transient ischaemic attack (mini-stroke)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the consequences of mesenteric ischaemia?

A

Ischaemic colitis
Malabsorption
Intestinal infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the consequences of peripheral vascular disease?

A

Intermittent claudication - blood supply to legs
Ischaemic rest pain
Gangrene

20
Q

What are the risk factors for atherosclerosis?

A 
Smoking
Hypertension
Age - progressive
Gender - women protected before menopause
Hyperlipidaemia 
Alcohol 
Diabetes mellitus
Infection
21
Q

What atherosclerosis prevention measures and interventions would you recommend to patients?

A 
Stop smoking
Decrease fat intake 
Treat hypertension 
Aspirin
Sensible alcohol intake
Exercise and weight control
Treat diabetes
Lipid lowering drugs if needed
22
Q

What cells are involved in plaque formation?

A 
Endothelial cells 
Platelets
SM cells
Macrophages
Lymphocytes
Neutrophils
23
Q

What are complications of aortic aneurysms?

A

Rupture - hypovolaemic shock
Thrombus formation
Embolism

24
Q

How does thrombomodulin prevent thrombosis?

A

Thrombomodulin binds to any locally formed thrombin and this complex initiates the anti‐coagulant effects of protein C and protein S

25
Q

How much does a lumen have to be occluded in order to significantly affect blood supply?

A

70-80%

26
Q

What is arteriolosclerosis?

A

Hardening of the arterioles, usually secondary to severe hypertension or diabetes mellitus.

27
Q

Where is a common site of arteriolosclerosis?

A

Kidney arterioles

28
Q

Briefly outline the events that lead to plaque formation.

A
  1. Chronic endothelial insult
  2. Lipid and monocytes cross endothelium and enter intima. Oxidised and form foam cells.
  3. SM cells migrate from media to intima and proliferate.
  4. Plaque grows - SM and foam cell proliferation. Fibrous cap formed.
  5. Cells in centre undergo necrosis, cholesterol crystals appear, angiogenesis from adventitia, calcification.
29
Q

When fibrosis occur in plaque formation?

A

Collagen, elastin and other matrix proteins form a fibrous cap.

30
Q

What are cholesterol clefts?

A

Holes where cholesterol has been removed during tissue processing

31
Q

Aneurysm usually occurs secondary to _________.

A

Atherosclerosis

32
Q

What are the 2 major complications of an aortic aneurysm?

A

Rupture and haemorrhage

Thrombus formation/emboli

33
Q

What is aortic dissection?

A

The inner layer of arterial wall tears open, blood enters and separates the media into 2 layers. Tear fills and can occlude artery.

34
Q

What are the 3 proposed mechanisms of atherosclerosis?

A
  1. Response to injury hypothesis
  2. Encrustation hypothesis
  3. Monoclonal hypothesis
35
Q

What is the response to injury hypothesis?

A

Atherosclerosis is a chronic inflammatory response of the arterial wall initiated by injury to the endothelium.
Progression by interaction between modified lipoproteins, macrophages, T cells and cells in arterial wall.

36
Q

What is the encrustation hypothesis?

A

Plaques are formed by repeated thrombi overlying thrombi. Lipid core derived from thrombi.

37
Q

What is the monoclonal hypothesis?

A

Each plaque is monoclonal. Is each plaque a benign tumour? Could it be induced by viruses?

38
Q

What role do endothelial cells have in atherosclerosis?

A
  • Altered permeability to lipoproteins
  • Collagen production
  • Stimulation of proliferation and migration of SM cells
39
Q

What role do platelets play in atherosclerosis?

A

Stimulate proliferation and migration of SM cells - PDGF

40
Q

What role do SM cells play in atherosclerosis?

A
  • Take up LDL to form foam cells

- Synthesise collagen and proteoglycans

41
Q

What role do macrophages play in atherosclerosis?

A
  • Oxidise LDL
  • Take up lipids to become foam cells
  • Secrete proteases that modify matrix
  • Stimulate proliferation and migration of SM cells
42
Q

What role do lymphocytes play in atherosclerosis?

A
  • TNF may affect lipoprotein metabolism

- Stimulate proliferation and migration of SM cells

43
Q

What role do neutrophils play in atherosclerosis?

A
  • Secrete proteases leading to continued local damage and inflammation
44
Q

What can cause endothelial injury and initiate plaque formation?

A

Hypertension
Toxins - cigarette smoke
Raised LDL

45
Q

What role do foam cells play in plaque progression?

A

Secrete cytokines which cause further SMC stimulation and recruit other inflammatory cells

Pathological Processes (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions