Atheroma

Question 1

List some risk factors for atheroma

Answer 1

1. Smoking
2. Hypertension
3. Hyperlipidaemia
4. Diabetes
5. Age
6. Sex (male)

Question 2

What is the pathogenesis for atheroma?

Answer 2

1. Endothelial injury
2. Accumulation of lipids/macrophages
3. Migration of muscle cells
4. Increase in size

Question 3

What is the fibrous cap of an atheroma formed of?

Answer 3

Collagen

Question 4

How does an atheroma progress to an atheromatous plaque?

Answer 4

1. Start as a fatty streak
2. Become fibrofatty plaque (contain cholesterol crystals)
3. Become a complicated plaque (with overlying thrombus)

Question 5

What negative effects do atheromatous plaques have?

Answer 5

1. Reduced artery diameter - easier to become blocked
2. Reduced overall blood flow
   If the affected artery is the only one to an organ, it is possible for the entire blood supply to be compromised

Question 6

What is stenosis, in relation to blood vessels?

Answer 6

Abnormal narrowing reducing luminal calibre and wall elasticity

Question 7

What is thrombosis?

Answer 7

Abnormal blood coagulation within a vessel

Question 8

What is an aneurysm?

Answer 8

Persistent blockage (due to thrombus) which cause ballooning of vessel behind blockage due to back pressure

Question 9

What is a blood vessel dissection?

Answer 9

Split in blood vessel wall

Question 10

What is an embolism?

Answer 10

Any blockage (embolus) within a blood vessel

Question 11

Define ischaemia

Answer 11

Lack of blood flow to a region of the body causing local tissue oxygen deprivation

Question 12

How does arterial stenosis affect:

1. Blood flow
2. Blood pressure?

Answer 12

1. Reduced

2. Increased

Question 13

What may happen in carotid arteries are affected?

Answer 13

Stoke, TIA, vascular dementia

Question 14

What may happen when peripheral arteries are affected?

Answer 14

Claudication, foot/leg/hand ischaemia

Question 15

What may happen if renal arteries are affected?

Answer 15

Hypertension, renal failure

Question 16

In cardiac ischaemia, low oxygen transport to heart muscle may result in what types of maladies?

Answer 16

1. Reduced exercise tolerance
2. Angina
3. MI
4. Cardiac failure

Question 17

What is cardiac fibrosis and how is it caused?

Answer 17

Loss of myocardium to fibrous tissue

Caused due to ischaemia which causes death of myocardium

Question 18

Why is cardiac fibrosis bad?

Answer 18

It leads to reduced contractility, reduced elasticity and decreased efficiency of the heart

Question 19

What are some common effects of arterial thrombosis?

Answer 19

1. MI
2. Cerebral infarction
3. Renal infarction
4. Bowel infarction

Question 20

Arterial thrombosis can lead to aneurysm formation - why?

Answer 20

1. The thrombus causes a blockage
2. Back pressure cause abnormal dilatation of the vessel
3. Reduced tunica media, smooth muscle and elastic stretch also contribute to the dilatation

Question 21

Where are some common aneurysm sites?

Answer 21

1. Abdominal aorta
2. Thoracic aorta
3. Circle of Willis

Question 22

What are the negative effects of an aneurysm?

Answer 22

1. Rupture
2. Pressure erosion on other structures i.e. oesophagus
3. Infections

Question 23

What is arterial dissection?

Answer 23

Splits within blood vessel media due to hypertension or other factors

Question 24

What are two negative effects of arterial dissection?

Answer 24

1. Blood clots within vessel walls

2. Sudden vessel collapse

Question 25

What is an athero-embolism and what does it cause?

Answer 25

Superadded thrombus and plaque material break off and embolise
Can cause cerebral or limb infarction and also generalised vasospasm/acute renal hypoperfusion in the kidneys