Atherosclerosis Flashcards
Formation order of an atherosclerotic plaque
1) LDL deposits in intima
2) monocytes infiltrate
3) atheroma forms
4) ruptures
5) formation of thrombus
6) ischemia
Two most commonly used drugs for atherosclerosis and subsequent complications
Lipitor (statin drug)
Plavix (anti-platelet)
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
Atherosclerosis
Foam cells are
monocytes/macrophages filled with lipids in fatty streaks
Factors that can injure endothelial tissue
HTN Smoking Toxins Viruses Hyperlipidemia Diabetes
Effects of LDL modifications (in regards to atherosclerosis)
Increased adhesion molecule expression
Expression of chemokines/receptors
Amplification of platelet activation
Release of factors from activated platelets, macrophages or vascular cells leads to…
smooth muscle emigration from media to intima
How does the phenotype of smooth muscle cells change during atherosclerosis
Lose contractility
Gain proliferative and migratory capacity
Gain synthetic capacity (extracellular matrix)
What cell type is most indicative of a fatty streak
Foam cells (macrophages filled with lipids)
Parts of a fibrofatty atheroma
Fibrous cap (collagen) Necrotic lipid core Residual intima media
An advanced/vulnerable plaque can progress into what possibilities?
Aneurysm and rupture
Occlusion by thrombus
Critical stenosis
Stage of atherosclerosis:
early lesion; precursor of atheroma; not significantly raised (no disturbance of blood flow); foam cells present
Fatty Streak
Stage of Atherosclerosis:
Intermeidate lesion; focal raised lesions, causing disturbed blood flow; have a fibrous cap and necrotic lipid core
Fibrofatty plaque
Stages of Atherosclerosis:
advanced lesion; calcification; potential rupture, plaque rupture and thrombosis
Complicated lesion
Major complications of complicated lesions
MI Ischemia Aneurysms Cerebral infarction PVD
Atherosclerosis most frequently affects what arteries?
Abdominal aorta
Popliteal arteries
Coronary arteries
Clots in arteries are referred to as (red/white) clots due to lots of (RBCs/platelets)
White; platelets
Clots in veins are referred to as (red/white) clots due to lots of (RBCs/platelets)
Red; RBCs
Why are venous/red clots treated with just anti-coagulants, as opposed to arterial/white clots?
Because they are fibrin rich, so need to affect the coagulation cascade
Thin fibrous cap, intense inflammation, high oxidative burden (stress), abundant macrophages, and large lipid core are factors of
unstable plaque
Thick fibrous cap, mild inflammation, mild oxidative burden (stress), low macrophage content, and small lipid core are factors of
stable plaque
What is seen in all children by age 10 in western countries?
aortic fatty streaks