Atherosclerosis

Question 1

What part of the artery is involved with athersclerosis?

Answer 1

The intimal layer

Question 2

What is the most important modifiable risk factor for atherosclerosis?

Answer 2

Cigarette Smoking

Question 3

How does the number of risk factors affect chance of developing Atherosclerosis?

Answer 3

2 RF = 4x risk

3 RF = 7x risk

Question 4

What is the threshold for coronary risk and total serum cholesterol?

Answer 4

As Tot Serum Chol rises above 160mg/dl risk rises linearly

LDL:HDL Ratio of 4:1.

Question 5

What are the Features of Familial Lipoprotein lipase deficiency(Type 1)?

Answer 5

Increased Chylomicrons

No premature Atherosclerosis (AS)

Question 6

What are the Features of Familial Hypercholesterolemia (Type IIa)?

Answer 6

Increased LDL

YES Premature AS

Question 7

What are the Features of Familial Combined Hypercholesterolemia (Type II b)?

Answer 7

Increased LDLand VLDL

Premature AS

Question 8

What are the Features of Familial Liproproteinemia Type III?

Answer 8

Increased IDL- Premature AS

LPL dysfunction

Question 9

What are the Features of Familial Hypertriglyceridemia (Type IV)?

Answer 9

Increased VLDL also

Premature AS

Question 10

What are the Features of Only Familial AI/CII deficiency (Type V)?

Answer 10

no HDL

SEVERE AS!!!

Question 11

What secondary disorders contribute to Atherosclerosis?

Answer 11

Nephrotic Synd
Hypothyroidism
Alcoholism
Diabetes Mellitus

Question 12

At what age does hypertension become a greater risk than hypercholesterolemia?

Answer 12

45 years old

Question 13

How is C reactive protein related to AS?

Answer 13

It is an inflammatory mediator. and AS is an inlammatory disease.
Not a marker or screening tool. Just a correlation

Question 14

How is Homocysteine related to AS?

Answer 14

caused by B12 and folate deficiency. thought to be a cause of AS

Question 15

What can cause endothelial injury?

Answer 15

HTN, smoking, LDL cholesterol

OVER EXPRESSION OF VASCULAR CELL ADHESION MOLECULE (VCAM1)

Question 16

What happens to macrophages when they endocytose lipids?

Answer 16

They form foam cells and fatty streaks

Question 17

What is the role of Macrophages in chronic inflammation?

Answer 17

Secrete Monocyte chemo attractant protein 1(MCP-1)
Attract macrophages
Foam cells secrete PDGF (stimulates Smooth muscle proliferation)
IL-1
TNF-a
TGF-B

Question 18

What is the result of calcification of arteries?

Answer 18

BVs become brittle

Question 19

Where are atherosclerotic plaques most likely to occur?

Answer 19

At branch points of Vessels

Question 20

What makes up a Vunerable plaque?

Answer 20

Soft with lipid filled core.
usually only 40-60% stenotic
Prone to rupture

Question 21

What are critical outcomes of atherosclerosis?

Answer 21

Aneurism and rupture
Occlusion and thrombus
Critical Stenosis

Question 22

Where do the most severe plaques occur? In the legs

Answer 22

More repeditive mechanical stresses and inflammation in the legs.

Question 23

What is Glasgov’s coronary remodeling hypothesis?

Answer 23

Compensatory expansion of BV to keep the lumen the same size until the serosa reaches the maximum stretch.

Question 24

What happened to worldwise disease in 2009?

Answer 24

People started dying more from chronic disease than acute disease.