Atherosclerosis and Dyslipidemia Flashcards
Atherosclerosis is a chronic inflammatory disorder of ____ sized arteries, predominantly of the ___ layer.
medium and large: coronary, abdominal aorta + branches, carotid, cerebral intimal
Atherosclerosis tends to occur on the opposite/same wall of flow division. Points of high/low shear stress, turbulence, and/or flow reverasal
opposite wall of flow dividers
low shear stress
What is vessel wall shear stress? How does low shear allow for atherosclersosi?
It is the frictional force exerted on the endothelium by blood flow.
Low shear allows increased lipoprotein particle residence time and increased ability of the particle to enter the subintimal space
how does oxidized LDL get created, and how does it affect atherosclerosis?
Reactive oxygen species from activated endothelium or inflammatory cells in teh arterial wall yields oxidized (modified) LDL.
This is ingested by macrophages through the scavnger receptor, not LDL-R, increases monocyte acumulation, stimulates release of growth factors and inflammatory response
macrophages in this arter are called __. how are they made?
When a macropahge ingests oxidized LDL, what does it beocme? foam cells
For atherosclerosis: we see proinflammatory situation cause adhesion of blood monocytes to activated ednothelium, must migrate into the intima and transform into macrophages and foam cells
Where do teh SMCs migrate from and to?
They migrate from media into intima, where they proliferate
What is shown here, stained with oil red O? Who has these?
Fatty streak: a childhood lesion, no symptoms but precursor to atherosclerotic plaqures
you see lipid in teh intima
What is shown here? How is it formed?
A fatty streak is a Type II lesion ,
Then, a fibrous plaque is when you see a necrotic lipid core (foam cell death, due to free cholesterol toxicity–you see cholesterol crystals in this core). + a fibrous cap: fibro-prolfierative SMCs secrete collage and ECM, many similaries to wound healing
Clinically relevant stenosis is an early/late phenomenon.
Late: because vessels compensatorily enlarge cross dimensional area due to plaque
What are complicated plaques?
Show stenosis, dystrophic calcification, and the thinning of the protective fibrous cap
LDL/ HDL is the primary culprit of CHD
LDL
HDL infusion in rabbits actually removed oxidized lipids, decreased monocyte migration, promtoes reverse cholesterol transport
look at the weird disorders please
Orange tonsils, undetectable HDL, sign of ___ Disease due to mutation in ____.
Tangier disease
mutation in ABCA1, which acts as a membrane bound transporter of phospholipids and cholesterol on acceptor proteins like Apo AI or Apo E
