Atherogenesis

Question 1

True or false: arterial circulation is fibrin rich

Answer 1

False
It is platelet rich, the venous circulation is fibrin rich

Question 2

What are risk factors for atherosclerosis?

Answer 2

Age
Tobacco smoking
High serum cholesterol
Obesity
Diabetes
Hypertension
Family history

Question 3

What initially causes inflammation in the arterial wall during beginning of atherogenesis?

Answer 3

LDL passing into and accumulating in arterial wall, undergoes oxidation and glycation causing endothelial dysfunction.

Question 4

Once inflammation has commenced by endothelial cells in response to oxidised and glycated LDLs in the artery wall, what happens?

Answer 4

Chemo attractants are released creating concentration gradient to recruit leukocytes

Question 5

Name 3 chemokines found in plaques and released during endothelial injury?

Answer 5

IL1
IL6
IFN-y

Question 6

Name the steps in recruitment of leukocytes to the artery walls in atherogenesis

Answer 6

Capture
Rolling
Slow rolling
Firm Adhesion
Transmigration

Question 7

What is the earliest lesion of atherosclerosis called?

Answer 7

Fatty streak

Question 8

Where do fatty streaks commonly appear?

Answer 8

Intimal wall of arteries typically in regions of disturbed flow where endothelial injury likely
eg bifurcations

Question 9

What are fatty streaks composed of?

Answer 9

Lipid-laden macrophages called foam cells
Smooth muscle cells
T lymphocytes
Extracellular lipid deposits

Question 10

Why are foam cells called foam cells?

Answer 10

Macrophages engulf the oxidised LDLs so macrophage accumulate lipid droplets in their cytoplasm which look foamy under microscope

Question 11

Foam cells promote inflammation (by releasing cytokines), oxidative stress and v_____ r____ within the arterial wall

Answer 11

vascular remodelling

Question 12

How do smooth muscle cells respond to cytokines released by foam cells?

Answer 12

Migrate from media to intima
Proliferate and produce collagen and proteoglycans

Question 13

What is an intermediate lesion composed of in atherosclerosis?

Answer 13

Foam cells
Smooth muscle cells
T lymphocytes
Aggregation of platelets to vessel wall
Extracellular lipid

Question 14

The accumulation of foam cells, smooth muscle cells and extracellular matrix proteins leads to formation of…

Answer 14

A fibrous plaque

Question 15

The fibrous plaque may protrude into the arterial lumen and impede blood flow. What does a vulnerable fibrous plaque consist of?

Answer 15

Thin fibrous cap overlying a lipid-rich necrotic core. (prone to rupture)

Also contains foam cells, T cells, vascular smooth muscle cells, fibroblasts, lipid)

Question 16

Overtime, atherosclerotic plaques my undergo _____ contributing to plaque stability.

Answer 16

calcification

Question 17

Calcification of atherosclerotic plaques may lead to arterial s____ and vascular function

Answer 17

stiffness

Question 18

What does an atherosclerotic plaque consist of?

Answer 18

Lipid core with necrotic debris containing smooth muscle cells, foam cells, macrophages, T lymphocytes with overlying by dense fibrous cap made of extracellular matrix proteins (collagen and elastin).

Question 19

What is an unstable fatty plaque, prone to rupturing called?

Answer 19

Thin Capped Fibroatheroma (TCFA)

Question 20

What happens to the fibrous cap in order for it to be maintained?

Answer 20

Resorbed and redeposited