atherosclerosis

Question 1

what is atheroscleoris

Answer 1

hardening of ateries due to non-plaque factors

Question 2

structure of artery wall

Answer 2

3 layers
tunica intima - inside layer
tunica media - smc - maintin bp - contract/dilate
tunica externa

Question 3

what is the development of atherosclerosis

Answer 3

1) endothelial cell injury
- caused due to elevated ldl, smoking, hypertension

2) migration of LDLs
- endothelial dysfunction allows the migration of excessive LDL into intima
- ldl gets oxidised

3) adhesion, migration and transformation of monocytes
- damaged endothelium expresses P-selectin and signalling molecules to attract monocytes to the damaged region
- monocyte adhere to p-selectin on EC and migrate into the intima and transform into macropaghes

4) engulfing ox-LDLs
- macrophages engulf all the ox-LDLs and become foam cells
- enhances the HDL reverse cholesterol

5)migration and proliferation

6) expansion and occlusion
- plaque grows towards the tunica externa
- then grows towards the lumen
- then plaque rupture and activate platelets and lead to thrombosis

Question 4

what are the risk factors

Answer 4

family history 
genetic factors 
ageing 
gender (male)
hyperlipideamia 
metabolic diseases (obesity)
smoking 
hypertension 

-Minor risk 
physical activity 
poor diet
heavy stress 
alcohol
medication

Question 5

what is the diagnoses

Answer 5

assymptomatic until event occurs

• blood tests
• electrocardiogram
• echocardiogram
• angiogram
• CT scan

Question 6

What are the treatment options for atherosclerosis (medication)

Answer 6

same as hyperlipideamia
antihypersensitives - ACE inhibitor, CCB and diuretics
anti-platlets drugs prevent thrombosis

Question 7

what are surgical procedures

Answer 7

-coronary angioplasty - catheter with balloon is inserted and inflated flattening the plaque
-coronary artery bypass graft
carotid endarterectomy - plaque is removed and stitched back up
carotid angioplasty - stent places
extracrainal to intracranial bypass