Atherosclerosis Flashcards
What part of the artery is involved with athersclerosis?
The intimal layer
What is the most important modifiable risk factor for atherosclerosis?
Cigarette Smoking
How does the number of risk factors affect chance of developing Atherosclerosis?
2 RF = 4x risk
3 RF = 7x risk
What is the threshold for coronary risk and total serum cholesterol?
As Tot Serum Chol rises above 160mg/dl risk rises linearly
LDL:HDL Ratio of 4:1.
What are the Features of Familial Lipoprotein lipase deficiency(Type 1)?
Increased Chylomicrons
No premature Atherosclerosis (AS)
What are the Features of Familial Hypercholesterolemia (Type IIa)?
Increased LDL
YES Premature AS
What are the Features of Familial Combined Hypercholesterolemia (Type II b)?
Increased LDLand VLDL
Premature AS
What are the Features of Familial Liproproteinemia Type III?
Increased IDL- Premature AS
LPL dysfunction
What are the Features of Familial Hypertriglyceridemia (Type IV)?
Increased VLDL also
Premature AS
What are the Features of Only Familial AI/CII deficiency (Type V)?
no HDL
SEVERE AS!!!
What secondary disorders contribute to Atherosclerosis?
Nephrotic Synd
Hypothyroidism
Alcoholism
Diabetes Mellitus
At what age does hypertension become a greater risk than hypercholesterolemia?
45 years old
How is C reactive protein related to AS?
It is an inflammatory mediator. and AS is an inlammatory disease.
Not a marker or screening tool. Just a correlation
How is Homocysteine related to AS?
caused by B12 and folate deficiency. thought to be a cause of AS
What can cause endothelial injury?
HTN, smoking, LDL cholesterol
OVER EXPRESSION OF VASCULAR CELL ADHESION MOLECULE (VCAM1)
What happens to macrophages when they endocytose lipids?
They form foam cells and fatty streaks
What is the role of Macrophages in chronic inflammation?
Secrete Monocyte chemo attractant protein 1(MCP-1)
Attract macrophages
Foam cells secrete PDGF (stimulates Smooth muscle proliferation)
IL-1
TNF-a
TGF-B
What is the result of calcification of arteries?
BVs become brittle
Where are atherosclerotic plaques most likely to occur?
At branch points of Vessels
What makes up a Vunerable plaque?
Soft with lipid filled core.
usually only 40-60% stenotic
Prone to rupture
What are critical outcomes of atherosclerosis?
Aneurism and rupture
Occlusion and thrombus
Critical Stenosis
Where do the most severe plaques occur? In the legs
More repeditive mechanical stresses and inflammation in the legs.
What is Glasgov’s coronary remodeling hypothesis?
Compensatory expansion of BV to keep the lumen the same size until the serosa reaches the maximum stretch.
What happened to worldwise disease in 2009?
People started dying more from chronic disease than acute disease.
