Atherosclerosis (Baumbach)

Question 1

<p>as the leading cause of cardiovascular disease, atherosclerosis accounts for nearly \_\_\_\_% of all deaths each year in the US</p>

Answer 1

<p>30%</p>

Question 2

<p>True or false: a large artery is classified as one that is greater than 2 mm in diameter.</p>

Answer 2

<p>True.

Small sized arteries: 100 μm - 2mm
Arterioles: 20-100 μm</p>

Question 3

<p>what compositional feature of an artery is its classification based on?</p>

Answer 3

<p>composition of tunica media

Large and medium sized arteries: multiple layers of smooth muscle
Small arteries: a few layers of smooth muscle
Arterioles: 1-2 layers of smooth muscle</p>

Question 4

atherosclerosis is a disease of _____ and ____ sized arteries.

Answer 4

large and medium sized arteries

Question 5

where do atherosclerotic lesions develop and stay confined within the artery?

Answer 5

they develop and are confined to the intima layer, which is a narrow zone of extracellular matrix between the endothelium of the vessel and the tunica media

Question 6

a type of atherosclerosis characterized by deposits of calcium in muscular arteries, which do not encroach on the lumen, and occurs in individuals >50

Answer 6

Monckeberg medial calcific sclerosis

Question 7

______ involves only arterioles and is relatively unique to chronic hypertension

Answer 7

arteriolosclerosis

Question 8

of the major potentially controllable risk factors of atherosclerosis, ____ appears by far to be the most important.

Answer 8

hyperlipidemia

Question 9

True or false: the first stage of atherosclerosis that is grossly and microscopically visible is the endothelial dysfunction stage.

Answer 9

False. Endothelial dysfunction includes changes in the permeability of the endothelium to circulating lipids followed by adhesion and emigration of monocytes. It is not observable

The first stage of grossly and microscopically visible atherosclerosis is fatty streak formation.

Question 10

the first grossly visible lesion in the development of atherosclerosis; it consists of aggregates of foam cells, which are lipoprotein-loaded macrophages, and may also include T cells, aggregated platelets, and smooth muscle cells

Answer 10

fatty streak

Question 11

the process of plaque growth and maturation is best exemplified by the formation of the _______, composed mainly of _______ cells; it interposes itself between the inner core of the plaque and the vascular lumen

Answer 11

fibrous cap; smooth muscle

Question 12

the fibrous cap forms a protective barrier between the circulating blood and the core of the plaque, which contains ______ factors.

Answer 12

clot-activating

Question 13

reduction of ______ in regions of turbulent blood flow (ie, branch points) is thought to be a major factor in initiating endothelial injury

Answer 13

shear stress

Question 14

oxidation of lipoproteins contribute to fatty streak formation, by attracting ______, which in turn ingest the oxidized lipoproteins

Answer 14

macrophages

Question 15

as a fatty streak continues to form, macrophages, T lymphocytes and platelets attracted to the injured endothelium combine to produce _______, which stimulate the migration of smooth muscle into the growing plaque.

Answer 15

platelet derived growth factor (PDGF)

Question 16

two major factors that lead to the development of an unstable fibrous clot

Answer 16

neovascularization and apoptosis

Question 17

what are the 3 arterial sites most often involved in atherosclerosis, and what are the major pathological consequences?

Answer 17

coronary arteries –> myocarial infarction
carotid arteries –> cerebral infarction
aorta –> aortic anuerysm

Question 18

in a ____ aneurysm, the vessel wall is ruptured and this results in hematoma formation on the outer surface that is confined by extravascular tissue, forming a bulge

Answer 18

false

Question 19

a ____ aneurysm is a bulge of the entire vessel wall, whose integrity remains unchanged

Answer 19

true

Question 20

which of these is the most common cause of aortic aneurysm?

A. infection
B. trauma
C. tertiary syphylis
D. cystic medial degeneration
E. atherosclerosis

Answer 20

E. All of the others are less common causes of aortic aneurysms.

Question 21

which of the following is NOT a chacteristic of atherosclerosis aneurysms (AAs)?

A. most commonly form in the coronary arteries.
B. complications include rupture, obstruction of adjacent vessels and embolism
C. rarely occur before the age of 40.
D. more common in males
E. may involve renal, iliac and mesenteric arteries

Answer 21

A. Atherosclerotic aneurysms most commonly occur in the abdominal aorta