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Pathology > Atheroma > Flashcards

Atheroma Flashcards

0
Q

What is atherosclerosis?

A

Progressive narrowing and hardening of the artery - result of atheroma. Potentially resulting in a complete blockage.

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1
Q

What is the definition of atheroma?

A

Build up of fatty material on the inside wall of an artery

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2
Q

Which 5 parts of the body does atheroma affect the most?

A

Lower abdominal aorta, coronary arteries, internal carotid arteries, popliteal arteries and vessels of circle of Willis.

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3
Q

What initiates atheroma?

A

Chronic injury to the endothelium resulting in chronic inflammation.

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4
Q

Give 4 causes of endothelium injury

A

Hyperlipidaemia, disturbed flow, smoking, hypertension.

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5
Q

How many stages of atheroma are there?

A

6

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6
Q

What happens during type 1 atheroma

A

Initial legion - isolated macrophage foam cells (from first decade)

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7
Q

Describe type 2 atheroma

A

Fatty streak lesion - mainly intracellular accumulation.

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8
Q

Describe type 3 atheroma

A

Intermediate lesion - lipid pools (third decade)

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9
Q

Describe type 4 atheroma

A

Fatty changes and core of lipid pool

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10
Q

Describe type 5 atheroma

A

Fibrotic and calcific layers form ( fourth decade)

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11
Q

What is type 6 atheroma

A

Surfaced defect - haemorrhage or thrombus.

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12
Q

What could atherosclerosis in he coronary artery cause?

A

Heart attack, angina ischaemic heart disease.

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13
Q

What could atherosclerosis in the aorta cause?

A

Aneurysm

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14
Q

What could atherosclerosis in the carotid arteries cause?

A

Stroke

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15
Q

What could atherosclerosis in the popliteal’s cause?

A

Peripheral vascular disease

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16
Q

List 5 complications of atherosclerotic plaques

A 
Aneurysm and rupture
Thrombosis
Haematoma formation
Embolisation
Development of critical narrowing of artery (stenosis)
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17
Q

What does chronic ischaemia result in?

A

Redness and loss of skin

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18
Q

List 3 other complications of atherosclerosis

A

Bowel ischaemia
Renal artery stenosis
Emboli

19
Q

How would you treat atherosclerosis?

A

Revasculisation

Secondary prevention

20
Q

How many deaths from ischemic heart disease are there a year?

A

60 deaths per 100 000

21
Q

How much does one MI increase your risk of developing heart failure and stroke by?

A

3-6 fold

22
Q

What happens during ischaemic heart disease?

A

In balance between supply (perfusion) and demand of the heart for oxygenated blood.

23
Q

As well as a decrease in oxygen in heart failure there is also…

A

Decrease in nutrient substrates and inadequate removal of metabolites.

24
Q

What might cause a decreased flow of oxygenated blood to the heart?

A

Atheroma
Embolism
Spasms

25
Q

What can cause an increase in demand for oxygen?

A

Thyrotoxicosis

Myocardial hypertrophy eg hypertension

26
Q

List four fixed risk factors for developing ischaemic heart disease

A

Age
Gender
Genetics
Positive family history

27
Q

List 7 reversible (with treatment) risk factors of IHD.

A 
Obesity
High cholesterol
Lack of exercise
Smoking 
Hypertension 
Diabetes
28
Q

Where is the common area for narrowing of the coronary arteries?

A

Left main coronary artery

29
Q

Who might have a silent MI?

A

Elderly and diabetic

30
Q

What are five signs and symptoms of an MI?

A 
Chest pain - crushing radiating down left arm and jaw
Shortness of breath 
Palpitations 
Syncope
Nauseous, sweating, pale
31
Q

What is stable angina?

A

Chest pain on exertion, relieved by GTN

32
Q

What is unstable angina?

A

Chest pain at rest as well as exercise can lead to MI

33
Q

Name the 2 different types of heart attacks

A

STEMI

NSTEMI

34
Q

Which is more severe NSTEMI or STEMI?

A

STEMI

35
Q

Stable angina is caused by?

A

Plaque disruption and spasm

36
Q

Unstable angina is caused by

A

Plaque disruption and spasm and partial thrombosis, possible emboli

37
Q

What investigations would you carry out on someone believed to have an MI?

A

Observations - pulse, BP, sats, resps
Bloods - trop
Chest x ray - fluid on lungs?
ECG

38
Q

What would you perform to find the location of the clot?

A

An angiogram

39
Q

List 7 complications of an MI

A 
Cardiac arrest
Arrhythmias
Pericarditis
Valvular defects
Ventricular wall rupture
DVT
PE
40
Q

What three treatments would you give to someone believed to be having an MI?

A

Oxygen
Pain relief
Aspirin

41
Q

What would you use to treat angina?

A

Nitrates
Lifestyle
Beta blockers

42
Q

What are 12 risk factors for developing atherosclerosis

A 
Hypertension 
Obesity
Diabetes mellitus
Smoking
Hyperlipidemia 
Family history
Low HDLS
age
Male
Physical inactivity 
Emotional stress
Homocystinuria
43
Q

What is LDL cholesterol?

A

Bad cholesterol delivered to peripheral tissue

44
Q

What is HDL cholesterol?

A

Good cholesterol removes bad cholesterol from tissues and takes to liver where it is excreted as bile.

45
Q

How can we prevent/modify atheroma?

A 
Stop smoking
Control hypertension
Weight reduction 
Increase exercise
Moderate alcohol 
Increase HDL and lower LDL.

Pathology (7 decks)

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