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Cardio Exam 2 > Atherosclerosis Inflammation > Flashcards

Atherosclerosis Inflammation Flashcards

1
Q

Define Atherosclerosis

A

SYSTEMIC disease of blood vessels characterized by intimal lesions called atheromas

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2
Q

Define Atheroma

A

Atherosclerotic plaque; hardening of blood vessels

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3
Q

Atherosclerosis is a disease of

A

arteries! NOT veins

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4
Q

Atherosclerosis Patho

A

Begins as a response to injury
Chronic inflammatory and healing response to injury
Lesions occur due to interaction between lipoproteins, monocytes and T cells with arterial wall

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5
Q

Monocytes become

A

Macrophages

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6
Q

7 Pathogenic events

A 
Endothelial injury
Accumulation of LDL and oxidation
Monocyte adhesion --> macrophages --> foam cell 
Platelet adhesion
SM cell recruitment
SM cell proliferation and ECM production
Further accumulation of lipids
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7
Q

Endothelial injury leads to

A

Loose tight junction = increased permeability and more adhesion molecules so things are coming in and getting stuck to the wall

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8
Q

SM cells

A

are normally in the media but they are recruited to the intima
Can proliferate and secrete ECM proteins

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9
Q

Oxidation

A

Chemical reaction where oxygen is attached to certain molecules
Lipids can interact with scavenger receptors now

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10
Q

Scavenger receptors

A

Macrophages are engulfing more and more lipids
They become full
Stimulate inflammatory mediators while dying which increases extracellular components

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11
Q

Two parts of atheroma

A

Core: filled with dying cell products

Fibrous Cap: collagen and endothelial cells

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12
Q

What size of fibrous cap do you want?

A

Thick because if it is thin it is more likely to rupture

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13
Q

Function of dendritic cells

A

Present antigen and activate T cells (without these there would be no T cell response)

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14
Q

Define Ulceration

A

Removal of the layer covering the plaque

DEEP

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15
Q

Erosion is

A

superficial

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16
Q

Rupture Process

A

SM cells, T cells and Macrophages are sitting in the plaque which it ruptures these are exposed to the blood leading to coagulation and thrombosis

17
Q

Two outcomes of rupture

A

Thrombosis will be small and will be incorporated and healed OR thrombosis will grow and occlude the blood vessel

18
Q

If you have occlusion in the coronary artery what happens?

A

MI

Most common cause of MI

19
Q

Microvessels

A

Portals for entry and exit of WBC from the atheroma
As WBC enter = inflammation increase = increased risk of rupture
Also can allow blood into the plaque = swelling of the plaque = occlusion

20
Q

Calcification

A

Deposition of calcium leads to thick, hard and stiff plaque making the blood vessel not able to respond to changes in blood pressure

21
Q

Most Common Manifestations of Atherosclerosis

A

No symptoms (most common)

22
Q

Define Compensatory enlargement

A

Normally narrow lumen of blood vessels increases due to occlusion

23
Q

Define Stenotic occlusive disease

A

Blood vessel is mostly occluded

24
Q

Define Aneurysm

A

Weakening of the blood vessel wall

25
Q

Thrombosis and rupture can cause

A

stroke

26
Q

Atherosclerosis in coronary artries

A

MI or angina pectoris

27
Q

Atherosclerosis in CNS

A

Stroke or encephalopathy (loss of neurons in the brain)

28
Q

Atherosclerosis in Peripheral circulation

A

Intermittent claudication and gangrene (necrosis)

29
Q

Atherosclerosis in Splanchnic circulatio

A

Mesenteric ischemia

30
Q

Atherosclerosis in renal artery stenosis

A

Hypertension

31
Q

Define Intermittent claudication

A

Pain in the lower extremities during exertion (running) and goes away during rest
Due to narrowing of the blood vessels that supply that area

32
Q

Define angina pectoris

A

Not occlusion of the blood vessel but stenosis is pressent

33
Q

Two types of strokes

A

Ischemic

Hemorrhage (rupture)

34
Q

Define Mesenteric ischemia

A

Inflammation in the intestines leads to ischemia
If the intestines rupture then you will have leakage of all that bacteria into the parietal cavity which will cause peritonitis (high mortality)

35
Q

Constiutional RF

A

Age
Gender (females are protected until menopause)
Family History

36
Q

Acquired RF

A 
Hyperlipidemia-Hypercholesterolemia
HTN
Smoking
DM
- Synergistic: if you have more than one = major increase in risk
37
Q

What can you test for as a biomarker of inflammation?

A

Protein C

Cardio Exam 2 (10 decks)

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