Atherosclerosis Flashcards

1
Q

What are the aetiologies of atherosclerosis?

A

Smoking
Hypertension
Hyperlipidaemia
Diabetes
Ageing
Sex
Genetics
High homocysteine levels

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2
Q

How does hypertension increase risk of vascular disease?

A

High blood pressure can damage endothelium and increases turbulence

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3
Q

How can diabetes lead to atherosclerosis?

A

It increases cholesterol levels and causes Advanced Glycation End products (AGE)
This causes abnormal cross linkage in vessel walls, increasing the risk of cholesterol trapping and causing firmer blood vessels

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4
Q

At what age can fatty streaks begin to form in blood vessel endothelia?

A

Around 10 years old

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5
Q

What are some examples of growth factors that allow for smooth muscle migration in vascular disease?

A

PDGF - Platelet Derived Growth Factor
FGF - Fibroblast Growth Factor
TGFα - Tissue Growth Factor alpha

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6
Q

What is meant by stenosis?

A

Narrowing

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7
Q

What are the 3 stages of atheroma progression?

A

Fatty streak
Fibrofatty plaque
Complicated plaque (With overlying thrombus)

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8
Q

What are some examples of complication of arterial stenosis?

A

Coronary artery - Myocardial infarction
Carotid artery - Stroke, vascular dementia
Renal artery - Hypertension, renal failure
Peripheral artery - Claudication, ischaemia

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9
Q

What is meant by ischaemia?

A

Lack of blood supply, leading to hypoxia, leading to damage

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10
Q

What are some complications of vascular disease?

A

Stenosis
Aneurysm
Dissection
Thrombosis
Embolism

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11
Q

What is meant by an aneurysm?

A

A site of abnormal and persistent dilation of an artery due to weakness in its wall

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12
Q

What are some common types of aneurysm?

A

Mycotic
Atherosclerotic
Dissecting
Arteriovenous
Traumatic
Syphilitic

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13
Q

Where is the most common site of aneurysm?

A

Abdominal aorta
AAA = Abdominal Aortic Aneurysm

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14
Q

What are some complications of aneurysm?

A

Rupture (Most likely above 6cm)
Thrombosis
Embolism
Pressure erosion of adjacent structures (Most common in syphilitic aneurysm)

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15
Q

What is an arterial dissection?

A

Splitting within the tunica media by flowing blood
Blood from the lumen can pass into a new path in the blood vessel wall
This leads to a false lumen which can allow pressure to build in the wall

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16
Q

What are some common risk factors of arterial dissection?

A

Atheroma
Hypertension
Trauma
Coarctation
Marfan’s Syndrome - Leads to aortic abnormality
Pregnancy

17
Q

How does hypoxia cause injury and cell death?

A

No Oxygen = No ATP
This stops function of the Na+/K+ pump and the Ca2+ pump
Increased K+ causes swelling
Increased Ca2+ Stimulates:
ATPase = ATP Breakdown
Phopspholipase = Phospholipid breakdown
Endonucleases = Cytoskeleton breakdown
Mitochondrial permeability = Cytochrome C release so intrinsic apoptosis

18
Q

What changes can be seen within the first 20 minutes of a myocardial infarction?

A

There is no microscopic changes but there are some changes to the persons ECG

19
Q

What occurs after 20 minutes of a myocardial infarction?

A

Cells begin to die
Hypoxic injury begins to occur causing apoptosis and necrosis
The cells swell at first due to K+ build up, but they then undergo pyknosis and begin to shrink
The cells become red and the nucleus shrinks
Marginal contractions bands appear

20
Q

What is meant by a tamponade?

A

A build up of fluid in the pericardium

21
Q

What is hyperaemia?

A

A build up of blood

22
Q

At what stage after a myocardial infarction does full scarring occur?

A

After 6 weeks

23
Q

What cells cause scarring after a myocardial infarction?

A

Fibroblasts begin to fill holes in tissue
Fibroblasts lay down collagen fibres