atherosclerosis

Question 1

Name some of the causes of atheroma

Answer 1

• smoking
• hypertension
• hyperlipidemia
• diabetes
• age (older)
• sex (males)
• genetics

Question 2

describe the pathogenesis of atheroma

Answer 2

• primary endothelial injury
• accumulation of lipids and macrophages
• migration of smooth muscle cells
• increase in size

Question 3

As atheromatous plaques enlarge ………… is compromised

Answer 3

blood flow

Question 4

How do atheromatous plaques progress and become complicated over time?

Answer 4

• fatty streak
• fibrofatty plaque
• complicated plaque
• progression is associated with further loss of luminal patency and arterial wall weakness

Question 5

when is atheromatous narrowing of an artery is likely to produce critical disease?

Answer 5

• it is the only artery supplying an organ or tissue
• artery diameter is small
• over all blood flow is reduced

Question 6

describe the complications of atheroma?

Answer 6

• stenosis
• thrombosis
• aneurysm
• dissection
• embolism

Question 7

describe arterial stenosis?

Answer 7

• narrowing of the arterial lumen
• reduced elasticity
• reduced flow in systole
• tissue ischaemia

Question 8

Describe the clinical effects of cardiac ischaemia?

Answer 8

• reduced exercise tolerance
• angina
• unstable angina
• MI
• cardiac failure

Question 9

describe cardiac fibrosis?

Answer 9

• loss of cardiac myocytes
• replacement by fibrous tissue
• loss of contractility
• reduced elasticity and filling

Question 10

What is the clinical effect of thrombosis?

Answer 10

infarction

Question 11

What is an aneurysm and where is the most common site?

Answer 11

• abnormal and persistent dilation of an artery due to a weakness in its wall
• abdominal aorta

Question 12

describe the complications of an aneurysm?

Answer 12

• rupture
• thrombosis
• embolism
• pressure erosion of adjacent structures
• infection

Question 13

describe arterial dissection?

Answer 13

• splitting within the media by flowing blood

- false lumen filled with blood within the media

Question 14

Describe the other associations with aortic dissection?

Answer 14

• atheroma
• hypertension
• trauma
• contraction
• marfans
• pregnancy

Question 15

Describe embolism?

Answer 15

• both superadded thrombus and plaque material may break off and embolism
• usual targets: cerebral infarct, renal infarct and renal failure, lower limb infarction