atherosclerosis

Question 1

tunica intima

Answer 1

endothelium, CT w BM,IEL

Question 2

Tunica media

Answer 2

smooth muscle cells

Question 3

External elastic lamina

Answer 3

outer 2/3rd supplied by vasa vasorum

Question 4

non modifiable

Answer 4

family history
gender
age MI inc 5 times risj from 40 to 60

Question 5

modifiable

Answer 5

hypercholestrolemia
weight
diabetes
smoking(endothelial damage)
homocysteine level
low folate
low vit b12
cuz they inc homocysteine

Question 6

pathogenesis

Answer 6

endothelial injury
creates prothrombic state
inc ENDothelin
inc TISSUE FACTOR]
(too far and end of the line)

Upregulation of I-CAM
V-CAM
selectin,

cause leukocyte adhesion and activation @ site of injury(ADHESION LAD)

Question 7

endothelial injury

Answer 7

prothrombic state
leukocyte adhesion
platelet activation and aggregation

LDL sneaks into intima
Oxygen free radicals formed
LDL’s Oxidized

Question 8

FOAM CELLS

Answer 8

LDL’s gets oxidized

bind to CD36 scavenger on the surface of macrophages»
FOAM
release cytokines and chemokines
T cells migrate into the intima( due to chemotactic cytokines and increased expression of leukocyte adhesion molecules)

Question 9

smooth muscle cells

Answer 9

gain the ability to to eat LDL and cholesterol synthesize extra amount of matrix protein and collagen

so they can divide and produce excess collagen to [produce a fibrous core over lipid core

Question 10

lipid core plaque has

areas of calcifcation necrosis cholesterol, oxidized ldl cellular debris

Answer 10

within plaque macrophages and smc can produce matrix metalloproteinases to digest fibrous cap

Question 11

atheroscleroletic plaque can cause

Answer 11

cystic medial necrosis severe thickening w impaired perfusion and dead smooth muscle

critical stenosis if it occupies more than 70 pc of vessel lumen

angina, TIA,,Claudication,renal artery stenosis