Atherosclerosis

Question 1

What vessels does atherosclerosis occur in?

Answer 1

large and medium sized arteries

Question 2

in their normal state are endotelial cells more vasodilated or constricted?

Answer 2

dilated…they also are anticoag and inhib growth in normal state

Question 3

name an important activator that will change the endothelial cell function?

Answer 3

lipid products/advaned glycosylation products

Question 4

when endothelial cells are injured, what 5 things can occur?

Answer 4

constrict
coagulate
inflammation (cytokine)
increase permeability 
growth promotion

Question 5

with an endothelial injury what cell types can leak in or adhere to the area (3)?

Answer 5

leukocytes
lipid deposition
platelet adhesion

Question 6

in LDL…what modifications happen that cause it to deposit in endothelial cells?

Answer 6

it will have chemokine receptors, activate platelets, and have adhesion molecule expression

Question 7

after lipid deposits in tunica intima…what happens?

Answer 7

smooth muscle will emigrate from media to intima and macros are activated

Question 8

what can macrophages and smooth muscle cells do to the lipid deposits? what does this lead to?

Answer 8

they can engulf them

inflammation

Question 9

what are the smooth muscle and macros called when they engulf the lipids?

Answer 9

foamy cells

Question 10

foamy cells are the cause of what in vessels?

Answer 10

the fatty streak

Question 11

now that inflammation, foamy cells, and lipid is all present, what happens in the tunica intima of the vessel?

Answer 11

smooth muscle proliferates with collagen and other ECM matrix deposition..more lipids too

Question 12

what does all the deposition lead to?

Answer 12

a necrotic core from foamy cell apoptosis and a fibrous cap made of collagen ECM and SMC

Question 13

in general terms what is the trigger of atherosclerosis and what is the mediator?

Answer 13

trigger is lipid metabolism problems and mediator is the endothelial dysfunction and immune response

Question 14

with worsening atherosclerosis…what are the three things that can lead to a clinical effect?

Answer 14

aneurysm from weakening wall

occlusion by thrombus

critical stenosis from growing plaque

Question 15

what age do we start to get fatty streaks?

Answer 15

about age 10

Question 16

after the fatty streak…what occurs next in formation of plaque?

Answer 16

fibrofatty plaque forms which is now a raised lesion with fibrous cap and necrotic core

Question 17

after the fatty streak and fibrofatty plaque what happens to the atherosclerosis plaque?

Answer 17

you get a complicated lesion from weakening tunica media or massive calcification or focal rupture of luminal surface that causes clotting

Question 18

angina definition

Answer 18

limiting flow in coronaries

Question 19

claudication definition

Answer 19

limiting flow in peripheral vessels

Question 20

two ways plaque buildup can cause infarcts

Answer 20

acute thrombosis from plaque rupture of intra plaque hemorrhage
or acute infarcts from emoblization of plaque fragments or thrombus

Question 21

what are the two most common artery for atherosclerosis

Answer 21

abdominal aorta and the coronary arteries

Question 22

name six risk factors for atherosclerosis

Answer 22

smoking, sedentary lifestyle, dyslipidemia, diabetes, hypertension

age and sex and genetics