AM L1.2 Progression of ATS

Question 1

Step 1 ENDOTHELIAL DYSFUNCITON

Accumulation of ….what? where?

Answer 1

Accumulation of LDL beneath the endothelial cells (in the subendothelial space).

Question 2

Step 1 What else might occur?

Answer 2

Modification of the LDL particles

Question 3

Step 1 What happens to the LDLs?

Answer 3

Oxidation of the LDL attracts monocytes

Question 4

Step 1 What do the monocytes do?

Answer 4

Monocytes adhere to the endotherlium and enter the subendothelial space

Question 5

Step 2 FATTY STREAK FORMATION

What is happening in the subendothelial space?

Answer 5

Monocytes are differentiating into macrophages.

Question 6

Step 2 Macrophages can takes up what?

Answer 6

oxidised LDLs… becoming foam cells… this is how ATS legions are formed - fatty streaks.

Question 7

Step 3 FIBROSIS PLAQUE FORMATION

What migrates where?

Answer 7

Smooth muscle cells migrate into the intima

Question 8

Step 3

what do the smooth muscle cells do?

Answer 8

secrete collagen and from the fibrous cap

Question 9

Step 3 What continues to happen?

Answer 9

Immune cells continue to accumulate in the subendothelial space

Question 10

Step 3 How is the lipid core formed?

Answer 10

Foam cells release cholesterol

Question 11

Step 4 PLAQUE RUPTURE

… this can result in

Answer 11

thrombosis and arterial occlusion

Question 12

Step 4 Plaque rupture can cause what conditions

Answer 12

angina, MI, sudden death

Question 13

Define infarction

Answer 13

cell death due to insufficient oxygen supply

Question 14

Stable plaques have…

Answer 14

smaller necrotic lipid core

Question 15

Vulnerable plaques have….

Answer 15

lipid rich/foam cells rich peripheral boundaries and thinner caps