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LSS: cardiovascular system > atherosclerosis > Flashcards

atherosclerosis Flashcards

1
Q

how has the prevalence of ischaemic heart disease changed?

A

has moved from number 5 to number 1

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2
Q

why has the prevalence increased?

A
  • diet has changed

- global increase in obesity, diabetes, hyperlipidemia and hypertension

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3
Q

what are modifiable risk factors?

A
  • smoking
  • lipid intake
  • blood pressure
  • diabetes
  • obesity
  • sedentary lifestyle
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4
Q

what are non modifiable factors?

A
  • age
  • sex
  • genetic background
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5
Q

what have been the changes in epidemiology over the last decade?

A
  • reduced hyperlipidemia
  • reduced hypertension
  • increased obesity
  • more diabetes
  • ## improvements in diabetes treatment
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6
Q

where do the fat deposits sit?

A
  • plaque happens at places with ordered blood flow
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7
Q

***what part of the artery does the fat bind to?

A

the fat binds to the intima

the LDL deposit in the subintimal space and binds to the matrix proteoglycans

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8
Q

*****how does atherosclerosis progress in terms of lesions?

A
  • as people get older the plaque grows in small steps rather than smoothly
  • when the plaque starts to break up it is dangerous
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9
Q

what are the main cell types involved in atherosclerosis?

A
  • vascular endothelial cells
  • monocyte macrophages
  • vascular smooth muscle cells
  • platelets
  • T lymphocytes
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10
Q

function of vasuclar endothelial cells?

A
  • barrier function

- leukocyte recruitment

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11
Q

function of monocyte macrophages?

A

monocytes turn into macrophages

  • needed for foam cell formation
  • cytokine and growth factor release
  • major source of free radicals
  • metalloproteinases
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12
Q

function of vascular smooth muscle cells?

A
  • migration and proliferation
  • collagen synthesis
  • remodelling and fibrous cap formation
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13
Q

function of platelets?

A

thrombus generation

- Cytokine and growth factor release

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14
Q

function of T lymphocytes?

A

Macrophage activation

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15
Q

what do macrophages do?

A

they are white blood cells derived from monocytes that if activated excessively can damage host tissue

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16
Q

what are the macrophage subtypes ?

what do they do ?

A
  • inflammatory macrophages
  • adapted to kill microorganisms
  • resident macrophages
  • normally homeostatic so suppress inflammatory activity
  • osteoclasts - calcium and phosphate homeostasis
  • spleen - iron homeostasis
17
Q

what is LDL ( low density lipoproteins)

A
  • bad cholesterol
  • synthesised in the liver
  • carries cholesterol from shelver to the rest of the body
18
Q

what s HDL? ( high density )

A
  • good cholesterol

- carries cholesterol from the peripheral tissues and arteries back to the liver

19
Q

what are oxidised LDLs?

A

due to the action of free radicals on LDL

-

20
Q

***what is the structure of LDL?

A

insert pic

21
Q

how does the LDL become modified?

A
  • LDLs leak through the endothelial barrier by uncertain mechanisms
  • the LDL is stuck by binding to the proteoglycans in the sub endothelial layer and become susceptible to modification
  • modification is normally oxidation
  • the LDL becomes oxidised by the free radicals and the oxidised LDL is phagocytesed by macrophages and causes inflammation
22
Q

***what is the overall mechanism of LDL -> chronic inflammation?

A

insert pic

23
Q

what is familial hyperlipidemia?

A
  • it is an autosomal genetic disease
  • which is basically massively elevated cholesterol
  • it is when the LDL cannot be cleaned form the blood
  • fatal
24
Q

what types of LDL receptors are there?

A

there are two types

25
Q

what happens if there is no LDLR?

A
  • the macrophages accumulate cholesterol
26
Q

what does the second LDL receptors do?

what are they called

A
  • they are called scavenger receptors since they hoover up chemically modified LDL
  • they accidentally bind to Oxidised LDL
27
Q

what are statins?

A

HMG coA reductase inhibitors

reduce plasma cholesterol

28
Q

what are the types of macrophage scavenger receptors?

A

macrophage scavenger receptor A

  • Known as CD204
  • Binds to oxidised LDL
  • Binds to Gram-positive bacteria like Staphylococci & Streptococci
  • Binds to dead cells

macrophage scavenger receptors B

  • Known as CD36
  • Binds to oxidised LDL
  • Binds to malaria parasites
  • Binds to dead cells
29
Q

what do macrophages do to LDL
using what enzymes?
step 1

A

macrophages modify the LDL

using. ..
- NADPH oxidase
- Myeloperoxidase

30
Q

what do macrophages do to the modified LDLs?

step 2

A

they accumulate the modified LDLs to become enlarged foam cells

31
Q

what do the plaque macrophages express?

A

inflammatory factors that are involved in monocyte recruitment

LSS: cardiovascular system (17 decks)

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