Atheroma Pathphysiology

Question 1

Define what an atheroma is and involves

Answer 1

Atheroma = fatty streaks with lipid laden macrophages

Formation of focal elevated lesions in intima of large/medium sized arteries

Question 2

Define what early atheromatous plaque is?

Answer 2

Just a yellow patch in the intima + LL macrophage

Question 3

Define what a fully developed atheromatous plaque is?

Answer 3

Central lipid core with fibrous tissue cap covered with arterial endothelial
Dystrophic calcification occurs late
Form arterial branching point

Question 4

Define what a complication atheroma is?

Answer 4

Estabished atheromatous plaque + haemorrhage into plaque ( calcification ) due to random rupture of the fiber cap

Therefore thrombosis

Question 5

Define what arteriosclerosis is and its aetiology alongside related diseases?

Answer 5

Smooth muscle hypertrophy due to dublication of internal elastic laminae

Intimal fibrosis causes decrease of vessel diameter

Aetiology = age related

Related diseases = Causes cardiac, cerebral, colonic renal ischaemia in elderly

Question 6

What is the aetiology of atheroma?

Answer 6

Mainly Hyperlipidaemia 
-hypercholesterolaemia 
-Signs based on: 
Bio evidence 
Corneal arcus
Xanthelasmata
-Lack of LDL receptors

Question 7

What are the risk factors of atheroma?

Answer 7

Premature
FH MI 
Genetic
Smoking
Diabetes
Hypertension

Question 8

For the pathophysiology of atheromatous plaques, what are the injury causes?

Answer 8

• Haemodynamic disturbances (turbulent flow)
  -Hypercholesterolaemia:
  ~Increases local reactive O2 species

Therefore: functionality is altered:

• enhanced expression of cell adhesion molecules
• High permeability for LDL
• Increased thrombogenecity

Question 9

For the pathophysiology of atheromatous plaques, what is the process of healing and inflammation?

Answer 9

1. Endothelial injury
2. Accumulation of LDL
3. Monocyte adhesion to endothelium -> migrate into intima so therefore, transform into foamy macrophage
4. Platelet adhesion
5. Factor release from activated platelets/macrophage -> smooth muscle cell requirment
6. SMC proliferation + extracellular matrix production and T cell recruitment
7. Lipid accumulation