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Nayla patho > Atherosclerosis > Flashcards

Atherosclerosis Flashcards

1
Q

What types of vessels develop atherosclerosis

A

Arteries

the only times veins do is when they are sed for bypass

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2
Q

What causes atherosclerosis

A

Endothelial damage due to metabolic derangements (DM) or physical force (BP), with deposits of platelets and lipoproteins (LDL) under the endothelium

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3
Q

What do LDL under the endothelium attract

A

Macrophages

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4
Q

What do platelets release

A

They release growth factors, which stimulate proliferation of smooth muscle cells in artery wall
This causes cholesterol and LDL accumulation in macrophages

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5
Q

What are foam cells

A

Macrophages filled with LDL’s

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6
Q

How are cholesterol crystals formed

A

lipid laden smooth muscle cells die and release lipid into interstitial spaces to be deposited as cholesterol crystals

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7
Q

What role do macrophages have after they phagocytize pieces of damaged smooth muscle cells

A

secrete cytokines and TNF, which stimulate collagen production (BAD, damage/hardening)

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8
Q

What leads to sclerosis (hardening)

A

the repair of initial arterial lesions with collagen depositions

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9
Q

What is an atheroma

A

a lesion that bulges into the lumen of the artery

It splits the tunica media

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10
Q

What is atherosclerosis related to

A

AGE!

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11
Q

What is the consistency of an atheroma

A

center is soft (lipid and cellular debris)

Outer covering is a fibrous surface cap (collagen and smooth muscle)

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12
Q

Can an atheroma be reversed

A

yes.

until secondary calcification, then it can’t be reversed

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13
Q

What is a major complication of an atheroma

A

local tissue degeneration causing hardening of the vessel (calcification)

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14
Q

Why are atheroma visible on XR

A

lipids released from dead cells attract calcium salts (radio dense)

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15
Q

What are RF for atherosclerosis

A 
Age 
Sex (male>female until menopause when they are equal)
Heredity (familial predisposition)
Lipid metabolism (lipid accumulation in atheroma)
Hypertension 
Obesity (HLD) 
Diabetes 
Cigarette smoking 
Stress (constant)
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16
Q

What can menopausal women do to reduce progression of atherosclerosis

A

Take replacement estrogen therapy

17
Q

What can modify the genetic predisposition to atherosclerosis

A

Healthy lifestyle and balanced diet

18
Q

What is familial hyperchoesterolemia

A

defect of LDL receptors not allowing lipoproteins into the liver
best known cause for familial atherosclerosis

19
Q

How does hypertension affect atherosclerosis development

A

elevated pressure of blood compresses intimal cells causing ischemia and cytokine release
Cytokine promotes proliferation of smooth muscle cells
-HTN also damages platelets causing aggregation

20
Q

What is diabetic microangiopathy

A

damage caused to small blood vessels due to hyperglycemia

21
Q

Who is aortic atherosclerosis most common in

A

older men
People over 50 with some degree of atherosclerosis
-Mildest forms found in young/middle aged pts with fatty streaks

22
Q

Whitman eventually happen to fatty streaks

A

they form atheromas (lipid rich bulging lesions)

23
Q

What happens when an atheroma ruptures

A

They become calcified, reducing elasticity of the vessel

24
Q

Is blood pressure affected by atherosclerosis

A

an atherosclerotic aorta is rigid and can’t adapt to changing blood pressures of a normal cardiac cycle
This leads to HTN in the vessel

25
Q

What does HTN in the aorta lead to

A

dilation of the inelastic aorta, forming aneurysms

26
Q

Where do aortic aneurysms most often occur

A

abdominal aorta

they are usually clinically silent

27
Q

What are berry aneurysms

A

small secular aneurysms at the base of the brain involving circle of willis

28
Q

What is the biggest fear with aortic aneurysms

A

rupture leading to death by exsanguination

Rupture can also cause dissection (second lumen)

29
Q

How can you treat an aneurysm

A

can be resected surgically and replaced by an artificial vessel made of Dacron or Gortex material

30
Q

What side of the heart do aneurysms usually occur on

A

Left (high pressure)

right has much lower pressure

Nayla patho (9 decks)

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