Atheroma

Question 1

What is atheroma?

Answer 1

The formation of plaques in the intima of artery walls

Question 2

What does atheroma in coronary arteries lead to?

Answer 2

Ischemia

Question 3

What is arteriosclerosis?

Answer 3

The thickening and hardening of artery walls reducing the the vessel’s diameter

Question 4

What is arteriosclerosis caused by?

Answer 4

Old age

Question 5

What does arteriosclerosis lead to?

Answer 5

Ischemia (various types)

Question 6

What are the 3 stages of development of an atheroma?

Answer 6

Fatty streak -> Early atheromatous plaque -> Fully developed atheromatous plaque

Question 7

What is the clinical significance of a fatty streak?

Answer 7

No clinical significance (just a small mass of lipid-laden macrophages)

Question 8

What age group are fatty streaks found in?

Answer 8

Children

Question 9

What age group are early atheromatous plaques found in?

Answer 9

Young adults onwards

Question 10

What is the structure of a fully developed atheromatous plaque?

Answer 10

A central lipid core with a fibrous tissue cap covered by arterial endothelium

Question 11

What provides the cap of atheroma with structural strength?

Answer 11

Collagens

Question 12

What resides in the fibrous cap of atheroma?

Answer 12

Inflammatory cells (macrophages, lymphocytes, mast cells, etc)

Question 13

Where are the cellular lipids from atheroma cores derived from?

Answer 13

Macrophages

Question 14

What occurs in the late stage of plaque development that is used as as a marker for atherosclerosis in angiograms or CTs?

Answer 14

Dystrophic calcification

Question 15

Where do atheromatous plaques usually form?

Answer 15

At arterial branching points (bifurcations)

Question 16

What clinically complicates atheromas? (3)

Answer 16

Plaque rupturing
Thrombosis
Calcification into plaque

Question 17

What is the largest risk factor for atheroma?

Answer 17

Hypercholesterolaemia (excess of cholesterol in the blood stream)

Question 18

What are 4 biochemical signs of major hyperlipidaemia (high lipid levels in bloodstream)?

Answer 18

LDL (low density lipoproteins)
HDL (high density lipoproteins)
Total cholesterol
Triglycerides

Question 19

What are 2 physical signs of major hyperlipidaemia?

Answer 19

Corneal arcus

Xanthelasmata

Question 20

What are 2 medical risk factors for atheroma?

Answer 20

Hypertension

Diabetes mellitus

Question 21

What are 3 social risk factors for atheroma?

Answer 21

Smoking
Male
Elderly

Question 22

What are the 2 steps in the process of atheromatous plaque development?

Answer 22

1. Endothelial lining of artery injured

2. Chronic inflammation and healing response of vascular wall

Question 23

What type of lipoprotein is responsible for atherosclerosis?

Answer 23

LDL

Question 24

What are 3 of the clinical consequences of the rupture of plaque leading to total occlusion?

Answer 24

MI
Stroke
Lower limb gangrene

Question 25

What aortic problem can arise from atheromatous ruptures?

Answer 25

Abdominal aortic anuerysm

Question 26

What are 5 lifestyle related therapeutic options to prevent consequences of atheroma?

Answer 26

Stop smoking
Control BP
Weght-loss
Exercise
Diet

Question 27

What 2 types of drug can be used to prevent consequences of atheroma?

Answer 27

Cholesterol lowering drugs

Asprin