Atherosclerosis, Thrombosis, Vascular Biology Flashcards
When you analyze blood lipids, what are the 3 things u can test for in the plasma?
total cholesterol, HDL, TG’s
Gib me the Friedewald eqn to predict LDL values
LDL = (Total Chol) - HDL - (TG’s/5)
only if TG’s are < 400mg/dL
This molecule is a varient of LDL with an ApoA protein covalently attached to it.
Lipoprotein A (LpA)
ApoA is structurally similiar to what plasma factor, thereby inhibiting normal clot lysis and leads to thrombus formation?
plasminogen
So if a pt has elevated LpA, what conditions are they at risk for?
coronary heart disease, cerbrovascular disease, atherosclerosis, thrombosis, and stroke.
Which vitamin can lower LpA levels by up to 20%?
Niacin
This is the marker that functions in immune reactions to bind to foreign materials or damaged cells to ID them as targets for phagocytosis.
CRP
Where is CRP made?
Liver
CRP is a good marker for the prediction for the risk of what events?
Cardiovascular events
holy balls i dont know how to write questions anymore.
After injury, what is the time span where CRP raises to very high levels in acute inflammation?
4-6 hrs
So if a pt has SLIGHTLY elevated CRP (3-10mg/L), what might be going on?
chronic, low grade inflammation
LIKE A PLAQUE BITCH
Which mediator is released by endothelial and SM cells to stimulated CRP release?
IL-6
This protein modifies lipid transport during inflammation and increases with atherosclerosis.
Serum amyloid A protein (SAA)
These are thin walled outpouchings of the arteries at the circle of willis.
Berry aneurysms
These are abnormal, small, direct connections between aa and vv.
Arteriovenous fistulas
What is the most common cause of arteriovenous fistulas?
developmental defects
This is focal, irregular thickening of the walls of the medium and large muscular aa.
Fibromuscular dysplasia
What 2 layers of the areteries undergo hyperplasia and fibrosis to cause fibromuscular dysplasia?
intima and and media
What are the pathological manifestations of fibromuscular dysplasia?
luminal stenosis, renovascular HTN, development of aneurysms
These are the cells that form a barrier and maintain homeostasis of the vessel.
Endothelial cells
How does endothelial cells maintain homeostasis throughout the bodayyy?
permeability barrier, elaboration of prothrombic molecules, ECM production, modulation of blood flow, regulation of inflammation and immunity, regulation for cell growth, oxidation of LDL
Endothelial cells are activated when exposed to what stimuli?
cytokines, bacterial products, hemodynamic stresses, lipid products that cause atherosclerosis, advanced glycosylation end products, viruses, complement components, and hypoxia
This is the condition when endothelial cells have an altered phenotype that impairs vasoractivity or induces a surface that is thrombogenic or abnormally adhesive to inflammatory cells.
Endothelial dysfunction
So if endothelial cells become sticky under dysfunction, what does that predispose the body to creating?
Thrombi
Vascular injury causes matrix synthesis which thickens which layer of the vessel?
Intima
This subtype of arteriolosclerosis is characterized by thickening with eosinophilic deposition, and usually results in coagulative necrosis.
Hyaline subtype
What 3 things is the hyaline substype of arteriolosclerosis associated with?
diabetic microagiopathy, aging, and HTN
This subtype of arteriolosclerosis occurs with severe HTN, which shows onion-skinning of the vessel, and usually accompanied by fibrinoid necrosis.
Hyperplastic subtype
These are dark purple cacific deposits in the tunica media of muscular arteries in people >50, and can undergo metplastic change into bone.
Moenckeberg medial sclerosis
What layer in the vessel does atherosclerotic plaques form?
Intima
Where in the world is atherosclerosis mostly found?
Western world and developed nations
Which ages are at risk for atherosclerosis?
40-60. but as u age u increase risk.,
Which gender is at risk for atherosclerosis?
perimenopausal woman < men < postmenopausal women
estogen is a protective factor.
Is there genetic component to atherosclerosis?
YESH
Which lipoprotein puts u at a higher risk for atherosclerosis?
LDL
Hypertrophy of which chamber of the heart puts u at a higher risk for atherosclerosis?
LV
How much is the death rate doubled by smoking 1 pack/day by ischemic heart disease (IHD)?
doubled
There is a 100x increased risk of atherosclerosis-induced gangrene in what condition?
Diabeetus
Just give me the atherosclerosis process from injury to the atheroma.
endothelial injury (irritants) –> endothelial dysfxn and monocyte adhesion –> smooth muscle recruitment and macrophage activation –> macrophage engulf lipids (foam cells) –> fatty streaks –> ECM deposition –> fatty adenoma
Which big ass artery is the most common location of atherosclerotic plaques?
abdominal aorta
What is the main targets of atherosclerosis? what size of vessels?
large and medium-sized muscular arteries
HOWEVER, which arteries is the most common location of atherosclerotic stenosis?
small aa.
What 3 things can happen in acute plaque change?
- rupture
- erosion/ulceration
- hemorrhage into the atheroma
A pipe-like rigidity and subsequent fragility is from what manifestation of atherosclerosis?
calcification
How can atherosclerosis cause a stroke?
embolization
A slowly growing atherosclerotic plaque with a thick cap in a coronary artery can cause what type of condition?
Angina pectoris
This blood lipoprotein is produced in the intestinal epithelial cells and carries TG’s in the blood.
Chylomicrons bitch
This blood lipoprotein is produced in the bloood, contains high concentration of cholesteol, and endocytosed by the liver and periphereal tissues.
LDL
This blood lipoprotein is produced in the liver and carries TG’s in the blood.
VLDL
This blood lipoprotein is produced in the blood from VLDL remnants and endocytosed by the liver or converted to LDL
IDL
This blood lipoprotein is produced in the liver and intestine, exchanges protein and lipids with other lipoproteins, and returns cholesterol from the tissues to the liver
HDL
By what reaction does HDL obtain cholesterol from other lipoproteins?
LCAT
By what protein does HDL deliver cholesterol to the liver?
CETP
What is the substance that smooth muscle cells secrete to thin the fibrous cap of atherosclerotic plaques?
metalloproteinases
After the cap has been thinned and rupture, internal plaque contents come in direct contact with procoagulant elements, leading to the formation of what?
thrombus
What chemical modifications to LDL can lead to atherogenesis?
oxidative dmg
High concentrations of which lipoprotein correlated with an increased risk of coronary artery disease, even in pts witch the lipid profile is otherwise normal.
LpA
This type of hyperlipidemia is caused from apoCII or LPL deficiency and causes increased chylomicrons and TG’s.
I (familial hypercholomicronemia)
This type of hyperlipidemia is caused from defect in LDLR, so there are increased LDL’s in the blood.
IIa (familial hypercholesterolemia)
This type of hyperlipidekmia is caused by inadequate LDLR internalization, leading to increased LDL, VLDL, and TG’s in teh blood.
IIb (familial mixed hyperlipidemia)
This type of hyperlipidemia is caused from many factors, leading to increased levels of VLDL and TG’s.
IV (familial hypertiglyceridemia)
This type of hyperlipidemia is caused from a defect in Apo E, leading to increased VLDL (IDL) and Tg’s in the blood.
III (familial dysbetalipoproteinemia)
This type of hyperlipidemia is caused from LPL deficiency + increased production of VLDLs, leading to VLDL, chylomicrons, and TG accumulations in the blood.
V (familial mixed hypertriglyceridemia)
This compound is the stabilizing component of cell membranes, and is the precursor to bile salts and steroids.
Choelsterol
What is the rate limiting step of cholesterol synthesis?
HMG-CoA reductase
What is the substrate and product for HMG-CoA R?
HMG-CoA –> mevalonate
Which drugs act of HMG-CoAR to stop cholesterol synth?
Statins
Which 2 foods offer delicious, nutritious essentials which lower the effect of starutated fats?
Veggies and fish
Which organ uses FA’s for surfactant protection?
lungs
Which tissues use Fa’s for beta oxidation?
muscles
What do free radicals from free iron and copper do to polyunsaturated FA’s?
peroxidate them
What are the peroxidated FA’s a risk for?
Athrogenic changes
