atheroma

Question 1

define atheroma

Answer 1

progressive disease (a.k.a. atherosclerosis) characterised by accumulation of lipids and fibrous elements in the large arteries, e.g. cholesterol

Question 2

list the risk factors of atheroma

Answer 2

modifiable

• high cholesterol (specifically higher low density lipoproteins (LDL) that transport cholesterol from liver to tissues)
• smoking
• hypertension
• smoking
• diabetes
• obesity and unhealthy diet
• sedentary lifestyle
• alcohol

non-modifiable

• male gender
• ageing
• low birth weight
• family history

Question 3

what was the WHO epidemiology on CVD?

Answer 3

• no. 1 cuase of death globally
• 17.9 million died of CVD in 2016 (31% of all global deaths)
• over 75% of CVD deaths take place in low and middle income countries

Question 4

what was the BHF epidemiology information about CHD?

Answer 4

• 1 death every 8 mins
• 1 in 7 men die from it
• 1 in 12 women (more than twice as many than from breast cancer)

Question 5

define acute inflammation

Answer 5

once harmful material has been removed or wound healed up, process stops and recovery follows

Question 6

describe process of acute inflammation

Answer 6

1. tissue damage caused (e.g. by trauma or bacteria)
2. damaged cell releases chemicals (e.g. histamine) and distress signals
3. causes increased blood flow and blood vessels to become leaky
4. distress signals attarct WBCs which digest germs and dead cells

Question 7

define chronic inflammation

Answer 7

same process as acute inflammation but no recovery, which leads to a constant state of alert

Question 8

define thrombosis

Answer 8

formation of stationary blood clot in the blood vessel

Question 9

define embolism

Answer 9

blockage of a blood vessel by an embolus

• embolus could be a blood clot or thrombus, air bubbles or foreign material)

Question 10

name the five stages of atheroma development

Answer 10

1. endothelial damage
2. inflammatory response
3. formation of fatty streaks
4. formation of atherosclerotic plaque
5. thrombus formation

Question 11

describe step one of atheroma development

Answer 11

endothelial damage

• initiates inflammatory response
• endothelium becomes leaky
• LDL can move into tunica intima (innermost layer of artery) and deposit cholesterol

Question 12

describe step two of atheroma development

Answer 12

inflammatory response

• inflammatory response attracts monocytes (WBCs)
• monocytes can move through the leaky endothelium
• within tunica intima, they transform into macrophages

Question 13

describe step three of atheroma development

Answer 13

formation of fatty streaks

• macrophages engulf cholesterol to form FOAM CELLS
• foam cells accumulate between endothelium, forming FATTY STREAKS

Question 14

describe step four of atheroma development

Answer 14

formation of atherosclerotic plaque

• foam cells become lipid-laden and degenerate, releasing contents
• fibrous tissue forms a hardened plque
• atherosclerotic plaque = lipid core with fibrous cap

Question 15

describe step five of atheroma development

Answer 15

thrombus formation

• plaque increases in size and ruptures
• activates the clotting crusade (trying to prevent contents spilling out)
• leads to thrombus formation