Atherosclerosis

Question 1

Pathogenesis

Answer 1

1. Endothelial damage
2. Production of cellular adhesion molecules
3. Monocytes and T cells attach to sticky surface
4. Migrate through arterial wall to subendothelial space
5. Macrophages take up oxidised LDL
6. Lipid rich foam cells
7. Fatty streak and plaque

Question 2

Complications

Answer 2

Stenosis
Thrombosis
Aneurysm
Dissection
Embolism

Question 3

Arterial Stenosis

Answer 3

Narrowing of arterial lumen
Reduced elasticity
Reduced flow is systole
Tissue ischaemia

Question 4

Cardiac fibrosis

Answer 4

Loss of cardiac monocytes
Replacement by fibrous tissue
Loss of contractility
Reduced elasticity and filling

Question 5

Clinical effects of superadded thrombosis

Answer 5

MI
Cerebral infarction
Renal Infarction
Intestinal Infarction

Question 6

Aneurysm

Answer 6

Abnormal persistent dilatation of an artery due to a weakness in its wall

Question 7

Commonest site for an aneurysm

Answer 7

Abdominal aorta

Question 8

Complications of aneurysm

Answer 8

Rupture
Thrombosis
Embolism
Pressure erosion of adjacent structures
Infection

Question 9

Arterial Dissection

Answer 9

Splitting within the media by blood flow
False lumen filled with blood within media
Sudden collapse = high mortality

Question 10

Embolism

Answer 10

Lodging of an embolus inside a blood vessel

Both superadded thrombus and plaque material may break off and embolise

Question 11

Usual targets of embolism

Answer 11

Cerebral infarct
Renal infarct
Lower limb infarction