78. Arteriosclerosis. (forms, risk factors, pathogenesis)

Question 1

Arteriosclerosis (definition, types)

Answer 1

definition: hardening of the arteries, arterial wall thickening and loss of elasticity

Types:
 1. Arteriosclerosis: hyaline and hyperplastic 
    arteriosclerosis
 2. Monckeberg medial sclerosis
 3. Atherosclerosis

Question 2

Arteriolosclerosis

Answer 2

small arteries and arterioles

1. Hyaline arteriosclerosis
   
   • patho: plasma protein leaking into vessel wall –>
     stenosis
   • cause: benign HTN, diabetes (non-enzymatic
     glycosylation of BM –> Blood vessel wall leaky –>
     proteins enter
   • kidney: benign nephrosclerosis
     (arteriolonephrosclerosis): glomerular ischemia –>
     glomerular scarring –> renal failure
2. Hyperplastic arteriolosclerosis
   
   • patho: hyperplasia of SMC –> narrowing of lumen
     (onion skin appearance) –> ischemia
     - progression: fibrinoid necrosis (pink fibrin-like
     appearance on H&E), death of blood vessel wall occurs
     in malignant HTN and vasculitis
     - cause: malignant HTN
     - kidney: malignant nephrosclerosis –> rapid progression
     to renal failure

Question 3

Monckeberg medial sclerosis

Answer 3

muscular arteries

patho: dystrophic calcification of internal elastic membrane (media layer) without getting to lumen layer

no association to inflammation, non-obstructive, not clinically significant

shows up on x-rays and mammographies

risk group: older ppl

Question 4

Atherosclerosis

Answer 4

large and medium size arteries

intimal thickening

characterized by intimal lesions called atheromas (or atherosclerotic plaque)