Atheroma and risk factors

Question 1

where is atheroma common internationally

Answer 1

developed world

Question 2

risk factors for atheroma

Answer 2

cigarette smoking 
hypertension
hyperlipidaemia
diabetes
age
sex
genetics

Question 3

4 stages of atheroma formation

Answer 3

primary endothelial injury
accumulation of lipids and macrophages
migration of smooth muscle
complication

Question 4

what can primary endothelial injury be caused by

Answer 4

smoking, hypertension, hyperlipidaemia, toxins, viruses, immune factors

Question 5

accumulation of lipids may be due to

Answer 5

higher LDL and lower HDL

V-CAM, IL-1 and TNF

Question 6

what might a plaque start off as

Answer 6

fatty streak

Question 7

when is atherosclerosis more likely to be complicated

Answer 7

only artery supplying an organ or tissue
small arterial diameter
blood flow reduced eg heart failure

Question 8

what are the complications of atheroma

Answer 8

stenosis - caused by ishaemia or fibrosis 
thrombosis
aneurism 
dissection
embolism

Question 9

what is stenosis

Answer 9

narrowing of arterial lumen
reduced elasticity
reduced systolic blood flow

Question 10

aortic thrombosis may embolise to cause…

Answer 10

cerebral, renal or intestinal infarction as well as lower limb

Question 11

what is dissection

Answer 11

splitting within media by flowing blood, creating a false lumen that may rupture through and through

Question 12

what conditions are aortic dissection common

Answer 12

atheroma, pregnancy, hypertension, trauma, coarctation, marfans

Question 13

what is aneurism and where is it common

Answer 13

common in abdominal aorta

abnormal and persistent dilation of an artery due to wall weakness

Question 14

types of aneurism

Answer 14

mycotic, atherosclerostic, dissecting, congenital, arteriovenous, traumatic, syphilitic

Question 15

incidence rates for CVD are increasing/decreasing

Answer 15

decreasing, but higher in men

Question 16

mortality rates for CVD are increasing/decreasing, and wealthy/deprived backgrounds are more likely to die

Answer 16

decreasing

deprived

Question 17

modifiable cardiovascular risk factors

Answer 17

smoking 
hyperlipidaemia 
hypertension
diabetes mellitus 
obesity
thrombogenic factors
exercise 
alcohol consumption

Question 18

non-modifiable cardiovascular risk factors

Answer 18

personal Hx CVD
FHx CVD
Age
Gender

Question 19

what risk category benefit best form CVD prevention

Answer 19

high risk, as most deaths occur in moderate risk

Question 20

ways to prevent CVD

Answer 20

lose weight 
limit alcohol intake 
increase physical activity
reduce salt intake 
stop smoking 
limit fat/cholesterol intake in food

Question 21

true/false - CAD is worse in men and they are more likely to die

Answer 21

false - it is worse in women

Question 22

HFpEF is more common in men/women

Answer 22

women

Question 23

who is more likely to suffer stroke from AF

Answer 23

women

Question 24

why are there worse outcomes for CAD in women

Answer 24

delayed presentation
less awareness
more comorbidity
Assessment/treatment/biological bias

Question 25

in women, when do they become more high risk to CAD?

Answer 25

post menopause, increasing with older age

Question 26

men with atherosclerosis have a stepwise decrease in BP when they pass a plaque. is this true for women?

Answer 26

no, female plaques progressively decrease blood flow across the entire vessel, not just in specific places

Question 27

Symptoms of MI in women

Answer 27

SOB, weakness, fatigue, aches, discomfort in arms, jaw, back
heartburn, nausea and vomiting

Question 28

What are risk factors for atherosclerosis in women that are neither modifiable or non modifiable

Answer 28

preterm delivery
hypertensive pregnancy disorders
autoimmune disease
depression
early menopause 
gestational disease

Question 29

how can women reduce mortality from CAD

Answer 29

prevention of CAD, maintain weight and cholesterol, exercise, blood glucose monitoring and DASH diet