atherosclerosis

Question 1

3 stages of plaque formation

Answer 1

fatty streak
fibrolipid plaque
complicated lesion

Question 2

fatty streak - way it works

Answer 2

• endothelial damage
• artery all more permeable in the intima layer
  macrophage adhesion to damaged endothelium so fats can enter this is called diapedsis
• the macrophages can turn into cytokines and cause smooth muscle cells to move into the intima
• LDL enter
• foamy macrophages ( macrophages with LDL that cannot be digested so fill up with fatty droplets and sit there)

Question 3

fobrolipid plaque

Answer 3

Smooth muscle cells
Migration to the surface of intermer and are followed by fibroblasts which aid to
-Proliferation
- Lipid uptake
- Production of collagen (which try and help but harm)

Sometimes the lipids break down and we get the formation of lipid lake- and we can get some of the lipids crystallising out to form crystals and these dissolve out in histological samples and these form cholesterol clefts in the section.
Lake of lipid with fibrious cap – endo are pulging into lumen and allows cells to impact onto the surface

Question 4

complicated lesions

Answer 4

• Occlusion
• Ulceration
• Thrombus formation- coagulated of blood constitutions
• This tends to happen when the fibrolipid plaque becomes ulcerated and endothelium cells are lost and platelets go onto surface
• Haemorrhage into plaques
• Plaque fissuring & rupture
• Embolism
• Calcification- calcium salts can be deposited in the artery - gritty
• Aneurysm formation- weakening of artery wall

Question 5

things that happen with the arteries and complicated lesions

Answer 5

Can get two things happen
small lipid take and lots of fibrous tissue leading to a small amount of narrowing
Large lipid lake and then thrombosis leading to angina(hurt when exerting) or to MI(complete blockage) and can leas to thrombosis /ruptured plaque and then heal and naroow the lumen more – fibrous intima

Question 6

Distribution of Atherosclerosis

Answer 6

Any large or medium size artery
Bifurcation-splitting of arteries
Coronary arteries
Cerebral arteries
Aorta
Mesenteric arteries- bowel ischemia
Femoral arteries

Question 7

management of atherolscleroisis

Answer 7

lifestyle: eating, excerise and non-smoking

medication 
ACE inhibitors 
Beta blockers 
CCB
diretics 
anti-platelets 
cholesterol-statins
Fibrinolysins- dissolve a blood clot

surgical 
bipas
angioplasty 
stents 
Endarterectomy- internal lining is removed and re edothelias

Question 8

consequences of atherosclerosis

Answer 8

Ischaemic heart disease
Angina pectoralis- on exercise on left arm
Myocardial infarction- heart muscle death
Heart failure- with time
Cerebral ischaemia and infarction- cause of one type of stroke
Aortic aneurysm
Small bowel ischaemia and infarction
Peripheral vascular disease- femoral
Intermittent claudication- pain in legs when exercise-n intermittent pain
Gangrene

Question 9

two forms of aneurysms

Answer 9

Weakening of blood vessel wall resulting in ballooning
Fusiform(spindle shaped) or saccular(like a grape shape-more likely to burst)

Complications:
Bursting, causing internal haemorrhage
Blood clots causing thrombosis or embolism within circulation and block vessel further down the stream