Atherosclerosis Flashcards

1
Q

Atherosclerosis

A

the gradual process by which plaque builds up on the body’s arterial walls

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2
Q

What is the fundamental precursor of atherosclerosis

A

endothelial injury

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3
Q

True or false: atherosclerosis is a chronic and progressive disease with a long asymptomatic period

A

true

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4
Q

What injurious agents in the bloodstream are endothelial cells exposed to during endothelial injury

A

oxidizing free agents, shearing force of high bp, high circulating glucose levels, elevated levels of LDL

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5
Q

Atherogenesis

A

the development of atherosclerotic plaque

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6
Q

What stimulates atherogenesis

A

inflammatory process from endothelial injury combined with high circulating LDL

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7
Q

3 steps of atherosclerosis

A

formation of foam cells, formation of fatty steaks and plaques, plaque rupture

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8
Q

How are foam cells formed

A

injured epithelium attract WBC which engulf and ingest LDL becoming foam cells

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9
Q

When is reverse transport unable to occur

A

if high LDL and low LDL creates plaque formation

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10
Q

How are fatty steaks and plaques formed

A

foam cells have fibrotic changes that protrude into vessel lumen

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11
Q

What does the formation of fatty steaks and plaques cause

A

causes narrowing and eventually calcified arteries, reducing wall elasticity and hardening arteries

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12
Q

How are plaques ruptured

A

a complex inflammatory process where inflammatory mediators allow clot formation and vessel spasm

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13
Q

What does constant remodeling increase the risk for

A

plaque rupture

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14
Q

What does plaque rupture do

A

attracts platelets and leads to release plaque or blood clots into the bloodstream, causing blockage

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15
Q

What occurs before MIs

A

plaque rupture

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16
Q

Clinical presentation of atherosclerosis

A

often no symptoms until organ dysfunction

17
Q

What should history be targeted at

A

determining risk factors and detecting atherosclerosis of coronary arteries, peripheral arteries of extremities

18
Q

Symptoms to look for of organ dysfunction

A

chest pain, leg pain, edema, SOB, palpitations

19
Q

Physical exam

A

BP, weight, heart sounds, presence of bruit, dependent edema, cyanosis, ophthalmic exam

20
Q

Labs

A

increase in lipid profile, c-reactive protein, homocysteine level

21
Q

When is endothelial function determined

A

during cardiac cath

22
Q

Why are CT scans easy diagnostic tools

A

no provider referral required

23
Q

What is the gold standard diagnostic test

A

cardiac angiography (but there are risks)

24
Q

Diagnostic tools

A

endothelial function, CT scan, cardiac angiography, intravascular ultrasonography

25
Q

Lifestyle changes

A

diet, activity, no smoking, reduce alcohol

26
Q

Statins

A

medications that diminish cholesterol synthesis in the liver

27
Q

Atorvastin

A

Lipitor

28
Q

Rosuvastatin

A

Crestor

29
Q

Simvastin

A

Zocor

30
Q

Surgical treatment options

A

CABG, PCI