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2 - CPR (cardio) > Arteriosclerosis/Atherosclerosis > Flashcards

Arteriosclerosis/Atherosclerosis Flashcards

1
Q

What is Arteriosclerosis?

A

“Hardening of Arteries”

= Wall thickening and decreased elasticity

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2
Q

What is Arteriosclerosis?

A

“Hardening of Arteries”

= Wall thickening and decreased elasticity

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3
Q

What are the 3 types of Arteriosclerosis?

A
  1. Arteriolosclerosis
  2. Atherosclerosis
  3. Monckeberg Medial Sclerosis
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4
Q

Arteriolosclerosis usually occurs in what type of vessels and what is the end result?

A
  • Small arteries and arterioles

= Downstream ischemic injury

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5
Q

Monckeberg Medial Sclerosis

A

Age related calcification of muscular arteries

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6
Q

Age related calcification of muscular arteries

A

Monckeberg Medial Sclerosis

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7
Q

What is the clinical manifestation of Monckeberg Medial Sclerosis?

A

NONE

- no narrowing, not clinically significant

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8
Q

What are the NON-modifiable risk factors for Atherosclerosis?

A 
Genetics - multifactorial inheritance
Increasing age (40-60) and MALE gender
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9
Q

What NON-modifiable factor is actually protective against Atherosclerosis development?

A

Premenopausal estrogenized women

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10
Q

What are the Modifiable risk factors for Atherosclerosis?

A
  • Hypertension and Hyperlipidemia
  • Metabolic syndrome, obesity, smoking, diabetes
  • Lack of exercise, stress
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11
Q

What are the Modifiable risk factors for Atherosclerosis?

A
  • Hypertension and Hyperlipidemia
  • Metabolic syndrome, obesity, diabetes, smoking
  • Lack of exercise and stress
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12
Q

What is the good cholesterol? What increases/decreases it?

A

HDL

  • Increases: Exercise and moderate alcohol
  • Decreases: Obesity and smoking
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13
Q

What is the bad cholesterol? What increases and decreases it?

A

LDL

  • Increases: Fried foods and animal products
  • Decreases: Fiber and statins
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14
Q

What things in the blood stream can be risk factors for Atherosclerosis?

A

Inflammation - C reactive protein
Homocysteine
LDL

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15
Q

Metabolic syndrome needs 3 of the 5 to diagnose. What are the 5?

A
  1. Insulin resistance
  2. Increased BP
  3. Decreased HDL
  4. Increased triglycerides
  5. Abdominal obesity
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16
Q

A majority of the pathogenesis of Atherosclerosis occurs in the ____ phase at a young age

A

Pre-clinical phase

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17
Q

The first step in developing Atherosclerosis is?

A

Endothelial injury/activation

18
Q

What things can injure/activate the endothelium?

A

Turbulent blood flow
Hypertension
Cytokines, lipids, etc.

19
Q

When the endothelium is injured/activated, what occurs to it?

A

INCREASED procoagulants, adhesion molecules and proinflammatory factors

20
Q

After endothelial activation/injury, what occurs next in the pathogenesis of Atherosclerosis?

A

Increased permeability, leukocyte and monocytes

21
Q

After increased permeability, what occurs next in the pathogenesis of Atherosclerosis?

A

Smooth muscle cell recruitment and macrophage activation

22
Q

Smooth muscle cells are recruited from where to where?

A

From the media layer, across the internal elastic lamina to the intima layer where they proliferate

23
Q

Macrophages are activated in the ____ layer

A

Intima

24
Q

Once macrophages and smooth muscle cells are in the initima layer, what do they do?

A

Engulf lipids and proliferate

25
Q

What is the final step of the pathogenesis of Atherosclerosis?

A

Smooth muscle cell proliferation and ECM (collagen) deposition

26
Q

What 3 factors can activate ECM (collagen) deposition with Atherosclerosis development?

A
  1. PDGF
  2. Fibroblast growth factors
  3. TGF-alpha
27
Q

What 3 factors can activate ECM (collagen) deposition in the development of Atherosclerosis?

A
  1. PDGF
  2. Fibroblast growth factors
  3. TGF-alpha
28
Q

What is at the core of the plaque in Atherosclerosis?

A

Necrotic cell debris and lipids/cholesterol

29
Q

What is overlying the core of the plaque in Atherosclerosis?

A

Fibrous cap - macrophages/smooth muscle/etc.

30
Q

What will be seen on the luminal side of Atherosclerosis?

A

Fatty streak

31
Q

Once Atherosclerosis reaches the Clinical phase, what 3 things can potentially occur?

A

Critical stenosis
Occlusion with thrombus
Aneurysm with rupture

32
Q

Balloon Angioplasty

A

Compresses and can rupture the plaque

33
Q

Thrombosis and spasm can cause abrupt reclosure of what Atherosclerosis intervention?

A

Balloon Angioplasty

34
Q

Coronary Metallic Stents

A

Expandable metallic mesh

35
Q

What can occur with Coronary Metallic Stents?

A
  • Endothelial injury
  • Thrombosis
  • Antithrombotic drugs have to be given to try and prevent restenosis
36
Q

What is the solution to restenosis after a coronary metallic stent was placed?

A

Drug - eliciting stents

37
Q

What do Drug - eliciting stents release?

A

Anti-proliferative drugs to block smooth muscle activation

38
Q

What do Drug - eliciting stents prevent?

A

Restenosis

39
Q

Vascular grafts can replace vessels or bypass them. When are synthetic grafts used?

A

Large vessels only

40
Q

Vascular grafts can replace or bypass vessels. What are the main autologous grafts used?

A

Internal mammary artery

Saphenous vein

2 - CPR (cardio) (44 decks)

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