Atherosclerosis

Question 1

Formation order of an atherosclerotic plaque

Answer 1

1) LDL deposits in intima
2) monocytes infiltrate
3) atheroma forms
4) ruptures
5) formation of thrombus
6) ischemia

Question 2

Two most commonly used drugs for atherosclerosis and subsequent complications

Answer 2

Lipitor (statin drug)

Plavix (anti-platelet)

Question 3

chronic inflammatory response in large/medium arteries; triggered by the accumulation of smooth muscle cells and lipids within the intima; can cause ischemia due to endothelial dysfunction

Answer 3

Atherosclerosis

Question 4

Foam cells are

Answer 4

monocytes/macrophages filled with lipids in fatty streaks

Question 5

Factors that can injure endothelial tissue

Answer 5

HTN
Smoking
Toxins
Viruses
Hyperlipidemia
Diabetes

Question 6

Effects of LDL modifications (in regards to atherosclerosis)

Answer 6

Increased adhesion molecule expression
Expression of chemokines/receptors
Amplification of platelet activation

Question 7

Release of factors from activated platelets, macrophages or vascular cells leads to…

Answer 7

smooth muscle emigration from media to intima

Question 8

How does the phenotype of smooth muscle cells change during atherosclerosis

Answer 8

Lose contractility
Gain proliferative and migratory capacity
Gain synthetic capacity (extracellular matrix)

Question 9

What cell type is most indicative of a fatty streak

Answer 9

Foam cells (macrophages filled with lipids)

Question 10

Parts of a fibrofatty atheroma

Answer 10

Fibrous cap (collagen)
Necrotic lipid core
Residual intima media

Question 11

An advanced/vulnerable plaque can progress into what possibilities?

Answer 11

Aneurysm and rupture
Occlusion by thrombus
Critical stenosis

Question 12

Stage of atherosclerosis:

early lesion; precursor of atheroma; not significantly raised (no disturbance of blood flow); foam cells present

Answer 12

Fatty Streak

Question 13

Stage of Atherosclerosis:

Intermeidate lesion; focal raised lesions, causing disturbed blood flow; have a fibrous cap and necrotic lipid core

Answer 13

Fibrofatty plaque

Question 14

Stages of Atherosclerosis:

advanced lesion; calcification; potential rupture, plaque rupture and thrombosis

Answer 14

Complicated lesion

Question 15

Major complications of complicated lesions

Answer 15

MI
Ischemia
Aneurysms
Cerebral infarction
PVD

Question 16

Atherosclerosis most frequently affects what arteries?

Answer 16

Abdominal aorta
Popliteal arteries
Coronary arteries

Question 17

Clots in arteries are referred to as (red/white) clots due to lots of (RBCs/platelets)

Answer 17

White; platelets

Question 18

Clots in veins are referred to as (red/white) clots due to lots of (RBCs/platelets)

Answer 18

Red; RBCs

Question 19

Why are venous/red clots treated with just anti-coagulants, as opposed to arterial/white clots?

Answer 19

Because they are fibrin rich, so need to affect the coagulation cascade

Question 20

Thin fibrous cap, intense inflammation, high oxidative burden (stress), abundant macrophages, and large lipid core are factors of

Answer 20

unstable plaque

Question 21

Thick fibrous cap, mild inflammation, mild oxidative burden (stress), low macrophage content, and small lipid core are factors of

Answer 21

stable plaque

Question 22

What is seen in all children by age 10 in western countries?

Answer 22

aortic fatty streaks