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CardioRespiratory 2 > Atherosclerosis and peripheral vasc disease > Flashcards

Atherosclerosis and peripheral vasc disease Flashcards

1
Q

Modifiable risk factors of atherosclerosis?

A 
smoking
lipid intake
BP
diabetes
obesity
sedentary lifestyle
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2
Q

What are non-modifiable risk factors atheroscleorsis?

A

Age
Sex
Genetic background

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3
Q

ABCD? Do decide which med to give

A

Ace inhibitors
Beta blockers
C
Diuretics

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4
Q

What can be given for obestiy?

A 
Weight loss
gastric surgert
metformin 
insulun 
dietry advice
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5
Q

What has reduced hyperlipidaemia over the last decade?

A

statin treatment

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6
Q

What has reduced hypertension over the last decade?

A

antihypertensive treatment

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7
Q

What has increased diabetes in the last decade?

A

Increased obesity

  • New improvements in diabetes treatment have doubtful effect on macrovascular disease
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8
Q

Which vessels are affected most by atheroscleorisis?

A

Coronary
Cerebral
Carotid
Iliac

tend to occur in bifurcations, branches, bends due to turbulent blood flow. This can cause inflammation

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9
Q

What is LDL deposition?

A

Atherescleorsis happens in between the internal elasric and intima usding LDL dposition

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10
Q

How doe LDL bind?

A

depost in subintimal space and binds to matrix proteoglycans

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11
Q

Describe the progression of atherosclerosis?

A

…

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12
Q

When is the window of opportunity for primary prevention?

A

….

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13
Q

When is clinical intervention eeded?

A

….

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14
Q

What is the role of vascular smooth. muscle cells?

A

…

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15
Q

What are vascular endothelial cell for?

A

…

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16
Q

What are Platelets for?

A

///

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17
Q

What are T lymphocytes for?

A

…

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18
Q

What did the cantos trial show?

A

Inflammation involved in atherosclerosis:

px at high risk injected with antibodies to IL-1

lead to fewer major adverse cardiovascular events - MACE

Multiple mechanisms including cholesterol crystal formation connect lipids and inflammation in atherosclerosis

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19
Q

what did zohaa say to jiya on 3/12/21 10:29?

A

im gonna be so lonely stuck in reynolds u better or i will replace u with the better rashid

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20
Q

what did zohaa say to jiya on 3/12/21 10:29?

A

im gonna be so lonely stuck in reynolds u better or i will replace u with the better rashid

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21
Q

macro

A

ysdsf

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22
Q

WHat two classes of macrophages are therw?

A

inflammatory

resident

23
Q

How are macrophage subtypes regulated?

A

combinations of transcription factors binding to regulatory sequences

24
Q

Why is white blood cell regulation vital?

A

cells can injure host tissue if they are activated excessively or inappropriately!

25
Q

WHich are the main inflammatory cells in atherosclerosis?

A

macrophages

26
Q

What do inflmmatory macrophages do?

A

Adapted to kill microorganisms (germs)

27
Q

Which resident macrophages are thee?

A

normal homeostatic - suppress inflammatory activity

alveolar resident macrophages - surfactant lipid homeostasis

osteoclasts - keep Ca + Phosphate under tight regulation

spleen - takes abnormal, old RBCs out of the blood

28
Q

Which resident macrophages are thee?

A

normal homeostatic - suppress inflammatory activity

alveolar resident macrophages - surfactant lipid homeostasis

osteoclasts - keep Ca + Phosphate under tight regulation

spleen - takes abnormal, old RBCs out of the blood *old rbc get stiff and stuck in narrow vessels of spleen == iron homeostasis

29
Q

What are LDLS, where are they made and taken?

A

.

30
Q

What are HDLs, what does it do?

A

.

31
Q

What are oxidised LDLs, modified LDLs?

A

.

32
Q

describe the structure of an LDL?

A

Centre : cargo fat for fuel, TG and CE

surrounded by lipid monolayer

cholesterol in membrane

apoprotein on top

33
Q

How are oxidised LDLs made?

A

LDLs leak through th endothelial barrier

LDL binds to maxtric proteoglycans in subendothelial layer = becomes susceptible to modification

LDL becomes oxidatively modifited by free radicals

34
Q

How do macrophages cause chronic inflammation via LDLs?

A

Oxidised LDLs are phagocytosed by macrophages and stimulates chornic inflammatipn

35
Q

WHat are foam cells?

A

When macrophage has take up LDLs

36
Q

What is familial hyperlipidemia?

A
  • Autosomal genetic disease
  • Massively elevated cholesterol (>~20 mmol/L). (effective ‘normal’ ~1-5 mmol/L)

Failure to clear LDL from blood.

= Xanthomas and early atherosclerosis;

if untreated fatal MYOCARDIAL INFARCTION before age 20.

37
Q

slide 24?

A

24

38
Q

macrophage receptor A?

A

//

39
Q

/macrophage receptor B\?

A

//

40
Q

WHich enzymes do macrophages have?

A

ocidative:

NADPH oxidase

Myeloperoxidase e.g.HOCl …

41
Q

How are monocytes recruited?

A

Plaque macrophages express inflammatory factors that are involved in monocyte recruitment.

42
Q

Which cytokines are involved with self perpetuating inflammation?

A

..

43
Q

Which chemokines are involved with self perpetuating inflammation

A

..

44
Q

What do VSMC do?

A

…

45
Q

How are VSMC recruited?

A

//

46
Q

What is platelet dderived growth factor used for?

A

…

47
Q

WHat does the transforming grwoth factor beta?

A

..

48
Q

How do normal medial vascularr smooth muscles become atherosclerotic?

A

…

49
Q

What are metalloproteinases? (expressed by mcarophaes)

A

Family of ~28 homologous enzymes.
Activate each other by proteolysis.
Degrade collagen.
Catalytic mechanism based on Zn.

50
Q

What are the effects of plaque erosion?.

A

Blood coagulation at the site of rupture may lead to an occlusive thrombus and cessation of blood flow.

51
Q

What are the chatacteristics of a vulnerable plaque which can become ruptured?

A

//

52
Q

describe macrophage apoptosis?

A

..

53
Q

What is the nuclear factor Kappa B?

A

TF

54
Q

How does NFkB coregulate different inflammatory genes?

A

,,

CardioRespiratory 2 (12 decks)

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