Atherosclerosis

Question 1

arteriosclerosis

Answer 1

thickening and loss of elasticity of arterial walls

Question 2

3 types of arteriosclerosis

Answer 2

monkeberg medial calcific sclerosis
- calcific deposits in muscular arteries that do not approach lumen

arteriolosclerosis
- narrowing of lumen in small arteries and arterioles

athersclerosis- narrowing of lumen in large arteries

Question 3

atherosclerosis characteristics

Answer 3

chronic inflammatory disease
large arteries
affects everyone
progresses w/ age
asymptomatic until a certain stage

Question 4

consequences of atherosclerosis

Answer 4

lesions mechanically obstruct blood flow

lesions rupture leading to atheroemboli and thrombosis

plaques weaken underlying media and lead to anerysms

Question 5

contributes more mobidity and mortality in western world than any other disorder

Answer 5

CAD, MI, stroke

Question 6

initial lesion formation

Answer 6

endothelial cells become permeable and leukocytes migrate into the vessel intima, becoming foam cells

these foam cells are visualized as fatty streaks, and are reversible

Question 7

atheroma formation

Answer 7

intimal thickening and lipid accumulation. lipid core of cholesterol and CE form

causes adherence and aggregation of platelets and leukocytes

protrude and obstruct vascular lumen, weaken the underlying tunica media

stable-covered by endothelium or fibrous cap

Question 8

fibroatheroma

Answer 8

atheroma plus production of collagen forming a plaque

Question 9

complicated plaques

Answer 9

stage at which symptoms appear- plaque ruptures

thinning of fibrous cap causes plaque rupture and hemorrhage from plaque microvessels

can cause calcification, ulceration, thromosis, or hemorrhage

Question 10

major manifestations of atherosclerosis

Answer 10

MI,
stroke
aortic aneurysms
peripheral vascular disease

Question 11

response to injury hypothesis

Answer 11

atherosclerosis is a chronic inflammatory response of the arterial wall initiated by injury to endothelium

lesion progression stustained by interaction b/t

oxidized lipoproteins, macrophages, t-cells, and cell wall

Question 12

endothelial loss vs endothelial dysfunction in atherosclerosis

Answer 12

loss- results in intimal thickening

dys- non-denuding dysfunction is most responsible for atherosclerosis

Question 13

two most common causes of athersclerosis

Answer 13

hemodynamic disturbances- turbulent flow

lipids- hypercholesterolemia
chronic lipid impairs endothelial cell function via ROS, damaging membrane and mitochondria

lipoproteins accumulate and become oxidized in the intima- uptaken by macrophage and smooth muscle, which die and form dead foam cells

Question 14

atherosclerosis risk factors

Answer 14

age (40-60), male, family history (most important), genetics

hyperlipidemia, hypertension, diabetes, c-reactive protein, smoking