Atheroma, Thrombosis and Embolism

Question 1

Define atherosclerosis

Answer 1

Degradation of arterial walls characterised by fibrosis, lipid deposition and inflammation which limits blood circulation and predisposes to thrombosis

Question 2

Which vessels are commonly affected by atherosclerosis?

Answer 2

bifurcations, abdomincal aorta, coronary arteries, popliteal arteries, carotid vessels, circles of willis

Question 3

What are some non-modifiable risk factors for atherosclerosis? (4)

Answer 3

age, gender, family history, genetics

Question 4

What are some modifiable risk factors for atherosclerosis? (4)

Answer 4

hyperlipidaemia, hypertension, smoking, diabetes

Question 5

What is the first step in atherosclerosis?

Answer 5

endotherlial injury

Question 6

What can cause endothelial injury?

Answer 6

haemodynamic injury, chemicals, immune complex deposition, irradtiation

Question 7

Where do lipids accumulate in atherosclerosis formation?

Answer 7

intima (inner most part of vessel)

Question 8

What causes the lipids in the intima to become foam cells?

Answer 8

monocytes which migrate into the intima

Question 9

What is the sequelae of atherosclerosis?

Answer 9

occlusion, weakening of vessel walls (aneurysm formation), erosion

Question 10

Define thrombosis

Answer 10

solidification of blood contents formed in the vessel during life

Question 11

Give 4 characteristics of clots that differentiate them from thrombus

Answer 11

form in stagnant blood, enzymatic process, elastic, adopts shape of vessel

Question 12

What are platelets?

Answer 12

fragments of megakaryocytes in the bone marrow

Question 13

What do platelets secrete?

Answer 13

alpha granule and dense granules

Question 14

What are the factors of Virchow’s triad?

Answer 14

intimal surface of vessel, pattern of blood flow, blood constituents

Question 15

What is the intimal change in venous thrombosis?

Answer 15

valves

Question 16

What is the name for thrombi in the heart?

Answer 16

mural thrombi

Question 17

What is the sequelae of thrombosis?

Answer 17

occlusion of vessel
resolution
incorporation into vessel wall
recanalisation
embolisation

Question 18

Define embolus

Answer 18

a mass of material in teh vascular system able to lodge in a vessel and block it

Question 19

What is the most common for of embolism?

Answer 19

pulmonary embolism

Question 20

Where do systemic emboli arise?

Answer 20

the heart (MI or AF), arterial circulation (atheroma)

Question 21

What normally causes infective emboli?

Answer 21

vegetation on infected heart valves

Question 22

How big must a gas embolism be to cause clinical effects?

Answer 22

> 100ml

Question 23

Who is at risk of decompression sickness?

Answer 23

divers and tunnel workers

Question 24

Can nitrogen bubbles enter bones, joints and lungs?

Answer 24

yes

Question 25

How do amniotic fluid emboli occur

Answer 25

increased uterine pressure during labour may force AF into maternal uterine veins

Question 26

What type of reaction does a foreign body embolism induce?

Answer 26

granulomatous reactioni