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Cardiovascular II > Atherosclerosis > Flashcards

Atherosclerosis Flashcards

1
Q

Calcification of the walls of muscular arteries, typically involving the internal elastic membrane. Does not encroach of vessel lumen and not clinically significant.

A

Monckeberg medial sclerosis

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2
Q

Two most important causes of endothelial dysfunction

A

Hemodynamic disturbances
Hypercholesterolemia and dyslipoproteinemias

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3
Q

Foam cells and their effect

A

Modified LDL accumulated in macrophages in hyperlipidemia

Directly impair endothelial cell function

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4
Q

Produced by inflammasome activation from foam cells

A

IL1

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5
Q

Result of inflammation in hyperlipidemia

A

Smooth muscle cell proliferation and synthesis of ECM proteins

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6
Q

Infections that can cause endothelial injury in vessels

A

Herpesvirus
CMV
Chlamydophila pneumonia

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7
Q

Factors that drive intimal smooth muscle proliferation and matrix synthesis to stabilize atherosclerotic plaques

A

PDGF
Fibroblast growth factor
TGF-alpha

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8
Q

Frequency of vessel involvement in atherosclerosis

A

Lower abdominal aorta
Coronary arteries
Popliteal A
Internal carotid A
Vessels in circle of Willis

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9
Q

Composition of fatty streak in atherosclerosis

A

Lipid filled foamy macrophages that coalesce

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10
Q

Intimal thickening plus lipid accumulation that encroach on vessel lumen

A

Atherosclerotic plaque

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11
Q

Composition of superficial fibrous cap on atherosclerotic plaque

A

Smooth muscle cells and relatively dense collagen

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12
Q

Shoulder of atherosclerotic plaque

A

Beneath and to the side of the cap. More cellular area containing macrophages, T cells, and smooth muscle cells

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13
Q

Deep to fibrous cap of atherosclerotic plaque

A

Necrotic core

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14
Q

Composition of necrotic core of an atherosclerotic plaque

A

Lipids
Debris from dead cells
Foam cells
Fibrin
Thrombus
Other plasma proteins

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15
Q

Type of lipids primarily found in necrotic core of atherosclerotic plaque

A

Cholesterol and cholesteryl esters

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16
Q

Possible pathologic changes in an atheromatous plaque

A

Rupture, ulceration, or erosion of the plaque surface
Thrombosis
Hemorrhage into plaque
Atheroembolism
Aneurysm formation

17
Q

Soft, velvety, yellow, flat papules or plaques on the eyelids

A

Xanthelasma

18
Q

Subcutaneous nodules on the Achilles tendon, associated with atherosclerosis

A

Tendinous xanthomas

19
Q

Possible physical exam findings in atherosclerosis

A

Xanthelasma
Tendinous xanthomas
Eruptive xanthoma
Arcus senilis

20
Q

Lipid deposit in cornea, common in elderly or younger with hyperlipidemia

A

Arcus senilis

21
Q

Complications of atherosclerosis in the coronary arteries

A

IHD
Exercise induce CP
MI

22
Q

Complication of atherosclerosis in the mesenteric artery

A

Ischemic colitis

23
Q

Complications of atherosclerosis in iliac A

A

Claudication pain
Limb gangrene
Impotence

24
Q

Complications of atherosclerosis in femoral and/or popliteal A

A

Claudication pain
Limb gangrene

25
Q

Complications of atherosclerosis in renal A

A

Elevated renin and aldosterone
Secondary HTN

26
Q

Complication of atherosclerosis in the subclavian A

A

Subclavian steal syndrome

27
Q

Indicator of significant atherosclerotic disease

A

Subclavian steal syndrome

28
Q

Exercise leads to ischemia due to increased metabolic demand in affected arm. Affected arm is perfused through retrograde flow in the ipsilateral vertebral A, leading to diminished posterior cerebral circulation. Pt has vertigo and lightheadedness 2/2 vertebrobasilar insufficiency.

A

Subclavian steal syndrome

29
Q

Early stage characteristics of atherosclerotic stenosis

A

Outward vessel remodeling
Preserved lumen patency

30
Q

Cut-off point for critical stenosis

A

Occlusion of 70% of vessel lumen

31
Q

Three general acute atherosclerotic plaque changes

A

Rupture/fissuring
Erosion/ulceration
Hemorrhage into the atheroma

32
Q

Characteristics of vulnerable atherosclerotic plaques

A

Thin fibrous caps
Large lipid cores
Greater inflammation

33
Q

Characteristics of stable atherosclerotic plaques

A

Thickening and densely collagenous fibrous caps
Minimal inflammation
Underlying atheromatous core

34
Q
A

Cardiovascular II (29 decks)

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