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Pathology (m) > Atheroma > Flashcards

Atheroma Flashcards

1
Q

Define atheroma

A

A build up of fatty material on the inside of the wall of an artery

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2
Q

Define atherosclerosis

A

the progressive narrowing and hardening within an artery potentially resulting in a complete blockage

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3
Q

Where can atheromas occur?

A 
Lower abdominal aorta
Coronary arteries
Popliteal arteries
Internal carotid arteries
Vessels of circle of willis
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4
Q

How may atheromas be initiated?

A

By chronic injury to endothelium resulting in chronic inflam

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5
Q

What may cause injury to endothelium?

A

Smoking
HTN
Disturbed flow
Hyperlipidaemia

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6
Q

How do atheromas progress?

A

As white cells, constituents of blood and fat

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7
Q

How are plaques formed?

A

A: Platelets activated
B: Platelets deposit chemokines on endothelial cells that compromise surface of arterial wall
C: Adhesion of monocytes to vessel wall
D: Monocytes then migrate into wall and turn into macrophages
E: LDL circulate and macrophages ingest them causing lipid rich foam cells
F: Foam cells mature into atherosclerotic plaques

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8
Q

What is a type 1 lesion?

A

Initial lesion

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9
Q

What is a type 2 lesion?

A

Fatty streak lesion

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10
Q

What is a type 3 lesion?

A

Intermediate lesion

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11
Q

What is a type 4 lesion?

A

Atheroma lesion

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12
Q

What is a type 5 lesion?

A

Fibroatheroma lesion

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13
Q

What is a type 6 lesion?

A

Complicated lesion

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14
Q

Clinical manifestation of an artery can cause…

A

Heart attacks
Angina
Ischaemic heart disease

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15
Q

Clinical manifestation of the aorta can cause…

A

Aneurysm

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16
Q

Clinical manifestation of the carotid artery can cause…

A

Strokes

17
Q

Symptoms of peripheral vascular disease…

A

Pain in both legs when walking

Infected ulcers on legs and feet needing abx

18
Q

Symptoms of stoke (cerebral infarction)…

A

Dysphasia
HTN with sudden onset
Left arm and leg weakness

19
Q

What other presentations may signify atheroma?

A

Bowel ischaemia
Emboli
Renal artery stenosis

20
Q

Treatment of atheromas?

A

Revascularisation (surgical)

Secondary prevention

21
Q

IHD is not only low o2 but…

A

Low nutrients substrates and inadequate removal of metabolites

22
Q

IHD means there is an imbalance between the…

A

Supply and demand of the heart for oxygenated blood

23
Q

Causes of IHD…

A

Low/no flow of oxygenated blood (due to atheroma, embolism, spasm)
High demand for o2 (thyrotoxicosis/htn)

24
Q

90% of IHD is caused by…

A

Coronary artery disease

25
Q

Fixed risk factors of IHD…

A

Genetics
Age
Gender
+ Fam history

26
Q

Potentially reversible risk factors with treatment…

A 
Hyperlipidaemia 
Smoking
HTN
Diabetes
Alcohol
Lack of exercise
Obesity
27
Q

Signs and symptoms of IHD…

A 
Chest pain (radiating to left and jaw)
SOB
Palps
Syncope
Nausea/sweating/pale
*NOTE: diabetic/elderly may not get chest pain*
28
Q

Clincal presentations of IHD…

A

STEMI
NSTEMI
Unstable/stable angina
Sudden death

29
Q

How can stable angina be relieved?

A

Rest and GTN spray

30
Q

Stable angina may be caused by…

A

Plaque disruption/spasm

31
Q

Unstable angina may be caused by…

A

Partial thrombosis/possible emboli

32
Q

STEMI/NSTEMI may be caused by…

A

Plaque rupture/occlusion with thrombus

33
Q

Name the complications of MI…

A

Cardiac arrest
Arrythmia
Pericarditis
Vulvular defects

34
Q

Common treatment to all ACS and angina…

A

O2
Pain relief
Aspirin

35
Q

Treatment for angina is…

A

Nitrates
B Blockers
Lifestyle changes

36
Q

ACS treatment…

A

Thrombolytic therapy
PTCA (procedure to open arteries)
CABG (bypass, improves blood flow to heart)
Drugs

37
Q

What does ACS include?

A

Unstable angina / MI

38
Q

Major risk factors for developing atherosclerosis…

A 
HTN
Diabetes
Hyperlipidaemia
Family history
Smoking
Low level of HDL
39
Q

Other risk factors for developing atherosclerosis…

A 
Obesity
Stress
Age 
Sex
Physical inactivity
Homocystinuria

Pathology (m) (11 decks)

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