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Fundamentals Of Science > Atheroma Formation And Atherosclerosis > Flashcards

Atheroma Formation And Atherosclerosis Flashcards

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1
Q

Atheroma define

A

Abnormal accumulation of fatty material in the inner wall (intima) of the artery

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2
Q

Atherosclerosis define:

A

Fat deposition in the walls of medium-sized and large arteries; progressive thickening and hardening of the arterial wall

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3
Q

Atherosclerosis around the body: coronary arteries

A

Coronary artery/heart disease: angina (chest pain) and myocardial infarction (heart attacks)

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4
Q

Atherosclerosis around the body: cerebral arteries

A

Cerebral vascular disease : transient ischemic attacks and stroke

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5
Q

Atherosclerosis around the body: peripheral arteries

A

Peripheral vascular disease : claudication (pain in lower limbs when walking) ; gangrene (due to lower limb ischaemia)

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6
Q

Risk factors of atherosclerosis : modifiable

A

High bp
High cholesterol
T2 diabetes
Obesity
Exercise
Smoking

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7
Q

Risk factors of atherosclerosis : non- modifiable

A

Age
Ethnicity
Gender
Family history

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8
Q

LDL vs HDL

A

LDL- BAD cholesterol
HDL - GOOD cholesterol

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9
Q

Timeline of atherosclerosis

A

Foam cells
Fatty streak
Intermediate lesion
Atheroma
Fibrous PLAQUE
Complicated. Lesion /rupture

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10
Q

TIA transient ischemic attack linked to?

A

High levels of LDL cholesterol in the body
Fatty collection =Leads to injury and inflammation

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11
Q

Inflammation in atherosclerosis explain

A

Present during all stages of atherosclerosis

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12
Q

Response to injury hypothesis : atherosclerosis

A

Chronic inflammatory and healing response of arterial wall to endothelial injury

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13
Q

Atherosclerosis progression:

A
  1. Endothelial dysfunction
  2. Endothelial injury
  3. Accumulation of cholesterol
  4. Formation of fibrous cap
  5. Plaque rupture
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14
Q

What is happening at stage 1 of atherosclerosis progression: endothelial dysfunction

A

Single layer of endothelial cells ; provide barrier
Decreased NO production = increased permeability = disruption of endothelial lining

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15
Q

What is happening at stage 2 of atherosclerosis progression: endothelial injury

A

Injured of endothelium initiates and inflammatory response
=increased expression of adhesion molecules
Monocytes attach and migrate into vessel wall

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16
Q

What is happening at stage 3 of atherosclerosis progression: Accumulation of cholesterol

A

LDL cholesterol enters the vessel wall
Monocytes-macrophages-foam cell
Fatty streak
T lymphocytes accumulate

17
Q

What is happening at stage 4 of atherosclerosis progression: fIBROUS CAP

A

Inflammatory state
Cytokines and growth factors get released from macrophages, platelets and endothelial cells
=cause proliferation and migration of SMCs-form fibrous cap overlaying fatty core

18
Q

What forms fibrous cap?

A

Cytokines and growth factor released= causing proliferation and migration of SMCs

19
Q

Late stage atherosclerotic plaque structure

A

Fibrous cap
Necrotic core
Media

20
Q

Necrotic core consists of?

A

Apoptotic cells, debris, cholesterol crystals, foam cells, calcium

21
Q

Media consists of?

A

SMC proliferation

22
Q

Lesion diversity : stenosis vs non-stenotic

A

Stenotic- thick cap, quite stable, few immune cells
Non-stenotic- thin cap, highly unstable, mainly immune cells

23
Q

What is happening at stage 5 of atherosclerosis progression:plaque rupture

A

Inflammation and immune cells promote plaque rupture
Rupture of the fibrous cap exposes the core of blood stream
Platelets are activated: coagulation cascade
Formation of blood clot (thrombus)

24
Q

Atherosclerosis treatment:

A

prevent it or its complication by targeting modifiable risk factors : hyperlipidaemia+hypertension + diabetes + smoking
Target obstructed arteries

25
Q

How might you prevent atherosclerosis or its complication by targeting modifiable risk factors

A

hyperlipidaemia- lipid lowering drugs (statins)
hypertension- lower blood pressure (anti-hypertensive drugs)
diabetes - lower blood sugar
Smoking- stop smoking

26
Q

How might you prevent atherosclerosis or its complication by targeting obstructed arteries ?

A

Coronary artery obstruction: stents , thrombolysis

27
Q

Statins work by?

A

Lowers cholesterol by competitive inhibition of HMG-CoA reductase (enzyme that catalyses the conversion of HMG-CoA to mevalonate )

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