Atherosclerosis and hyperlipidaemia

Question 1

What is atherosclerosis

Answer 1

Slowly progressive disease where there is a build up of plaque in the arteries reducing the blood flow and eventually becomes a site of thrombus formation

Question 2

Hyperlipidaemia

Answer 2

High levels of lipids and cholesterol in you blood

Question 3

Sources of cholesterol

Answer 3

Diet
from the liver

Question 4

What is the visible sign of atherosclerosis

Answer 4

Fatty streak on the lining on the lumen

Question 5

what are foam cells

Answer 5

Large subendothelial inflammatory cells that eat up lipds

Question 6

How does atherosclerosis form

Answer 6

• build up of streaky fat deposits in the lumen of the arteries
• accumulation of foam cells
• ## continues to grow and plaques from causing clinical atherosclerosis

Question 7

What is contained in plaque

Answer 7

• lymphocytes
  -macrophages
  -cholesterol
  -Lipids
  -

Question 8

How does atherosclerosis occur

Answer 8

ytes adhere to the lumen wall and enter the sub-endothelium where it’s turned into macrophages this causes the release of o2 radicals which oxidises the LDL and causes damage to the lumen and activate adhesion molecules.
- oxidises LDL damage bind to receptor cells on the macrophages and undergo phagocytosis and Turing them into
- macrophages then consumes oxidised lipoproteins which turns them into foam cells
- foam cells accumulate and releases growth factors and cytokines which causes the migration of smooth muscles cells to the intima (subendothelium)
- this produces an extracellular matrix

Question 9

What is the progression of atherosclerosis plaques

Answer 9

• starts of as fatty streaks which are present in young people, these streaks are most vulnerable to causing a haemorrhage (damaged blood vessel) and fissuring (breaking off). When smooth muscles cells migrate to the intima, it can produce a dangerous fibrous cap containing a lot of different cells that make it tough substance lining the lumen.

Question 10

What are the types of atherosclerosis plaques

Answer 10

• unstable/ vulnerable plaques
  Thin fibrous cap and mostly made up of lipid material and is prone to cause ulceration
• sable plaques
  Stable because of the fibrous cap

Question 11

What are the causes of atherosclerosis

Answer 11

• hyperlipidaemia
• smoking
• inherited disorders
  -secondary disorder:
  Liver failure
  Nephrotic syndromes (kidney)
  Hypothyroidism (excess production of thyroid hormone),

Question 12

What are the consequences of atherosclerosis

Answer 12

• Narrowing of the lumen leading to ischaemic heart diseases
• stiffening of the vessel wall
• thrombus formation and

Question 13

Can atherosclerosis be stopped

Answer 13

No however it can be slowed

Question 14

How can atherosclerosis be slowed

Answer 14

• change diet, reduces cholesterol and lipids
• stop smoking
• control diabetes and blood pressure
• increase exercise

Question 15

What pharmacological strategies can be used to reduce lipids

Answer 15

• prevent cholesterol synthesis using HMG-coA reductase inhibitors
• prevent cholesterol reabsorption
• increase production of lipoprotein lipase
• reduction of VLDL

Question 16

What drug is used to inhibit cholesterol synthesis

Answer 16

-Statins such as lovastatin and atorvastatin,
-They work by inhibiting HMG-coA reductase that blocks the production of cholesterol
- side effects are that it can damage the skeletal muscles or liver. Also shouldn’t be taken when pregnant as can damage the myelination of infants

Question 17

What drugs an be used to prevent cholesterol absorption

Answer 17

-Resins such as cholestyramine,
- they are non-absorbable macromolecules that bind to cholesterol that stop it from being absorbed
- side effect are that is has a bad taste and can bind to vitamins or other drugs stopping absorption
-

Question 18

What drugs can be used to stop VLDL absorption

Answer 18

Niacin (nicotinic acid) and vitamin b3
Side effects, itching and glucose intolerancew

Question 19

What drugs can be given to increase the synthesis of lipoprotein lipase

Answer 19

• fibrates such as gemfibrozil, fenofibrates
• activates PPARA alpha which increases lipoprotein lipase synthesis and beta oxidation of lipids
• side effects include nausea, skin rash and increase in gall stones