Atherosclerosis (MCQ)

Question 1

What is cornornary artery disease ?

Answer 1

Th gradual narrowing of the arteries that supply the blood to the heart

Fatty deposits begin (plaque) begins to form in the inner lining of the artery, this develops in the childhood and thicken through into adulthood
The thickening is called “atherosclerosis”

Question 2

Name the stages of atherosclerosis

Answer 2

Plaque formation
Plaque progression
Plaque destabilisation
Plaque rupture
Thrombus formation

Question 3

Explain plaque formation ?

Answer 3

Damages the endothelium and starts the inflammatory process
Vasoconstriction due to endothelial dysfunction, blood gets stickier, WBC attracted to the area, they cause oxidative stress and lots of inflammation. bad cholesterol (LDL) passes through the area where it oxidises and then engulfed by macrophages. Then foam cells begin to formation and that begins the fatty streaks along the sub endothelial layer
Collagen migrates over the fatty streaks which forms fibrous plaque, separating the thrombogenic core from the blood that passes over it

Question 4

Explain plaque progression

Answer 4

This will consist of smooth muscle cells and collagen bridges which cross link and stabilise plaque
Atheroma will develop further as time passes, usually at bifurcations, narrowing the lumen and will result in ischaemia

Question 5

Explain plaque destabilisation

Answer 5

There are lots of inflammatory cells in the area
They release Proteases and collagenases
Dissolve cells and collagen bridges that protect the fibrous cap
Smooth muscle cells try and divide and recover
Results in ulcerations/fissures in the plaque
Now unstable plaque

Question 6

Characteristics of high-risk plaques

Answer 6

Large lipid core
Thin fibrous cap
High density macrophages and t lymphocytes
Erratic outward remodelling

Question 7

Explain a plaque rupture

Answer 7

Ulcerations/fissures allow the blood platelets to come into contact with the thrombogenic plaque core
Starts the clotting process
Thrombus information (white thrombus)
Actuate intravascular thrombus = acute coronary syndrome

Question 8

How much fatal MI’s are caused by plaque ruptures ?

Answer 8

75%

Question 9

What is a broken free thrombus called ?

Answer 9

A thrombus that breaks free an migrates is called a “embolus”