B2.006 Acute MI Underlying Pathology Flashcards

1
Q

What is atherosclerosis?

A

intimal based lesion composed of a fibrous cap and atheromatous core (necrotic center)

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2
Q

What are some inherited/constitutional risk factors for atherosclerosis?

A

genetic, age, gender

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3
Q

What are some modifiable risk factors for atherosclerosis?

A

hyperlipidemia, hypertension, cig smoking, diabetes

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4
Q

What are the 5 main steps of atherosclerosis?

A
  1. chronic endothelial “injury”
  2. endothelial dysfunction and emigration
  3. macrophage activation, smooth muscle recruitment
  4. macrophages and smooth muscle cells engulf lipid
  5. smooth muscle proliferation, collagen, and other extracellular matrix deposition, extracellular lipid
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5
Q

What causes hardening in plaques?

A

calcium deposits

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6
Q

What is neovascularization?

A

blood vessels form within plaque, making the plaque susceptible to blood leakages and inflammation

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7
Q

What are some major sources of endothelial “injury”?

A

hyperlipidemia, hypertension, smoking, toxins, hemodynamic factors, immune rxns, viruses

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8
Q

What are the major structural components of a blood vessel?

A

lumen, endothelium, intima, internal elastic membrane, media, adventitia

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9
Q

What makes a plaque unstable?

A

thin fibrous cap, neovascularization, calcium deposits

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10
Q

What are the 3 primary clinical results of a vulnerable plaque?

A

aneurysm and rupture, occlusion by thrombus, and critical stenosis

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11
Q

What can cause an aneurysm?

A

mural thrombosis, embolization, wall weakening

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12
Q

What can cause occlusion by thrombus?

A

plaque rupture, plaque erosion, plaque hemorrhage, mural thrombosis, embolization

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13
Q

What can cause critical stenosis?

A

progressive plaque growth

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14
Q

What is the most common cause of death in the US?

A

atherosclerosis

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15
Q

What are 3 types of CAD?

A

MI, angina pectoris, sudeen cardiac death

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16
Q

What are consequences of atherosclerosis outside of the heart?

A

cerebrovascular disease, aneurysms, peripheral vascular disease

17
Q

What is an anabolic circuit?

A

More intake, less expenditure

18
Q

What is a catabolic circuit?

A

less intake, more expenditure

19
Q

What types of circuits are associated with obesity?

A

anabolic

20
Q

What are 3 major consequences of obesity?

A

metabolic syndrome, type 2 diabetes, proinflammatory state

21
Q

What is hyperinsulinemia and what is a risk factor and result of the condition?

A

persistently high level of insulin in the body, obesity is a risk factor, potent stimulation of cell proliferation is a result

22
Q

What are some consequences of being in a proinflammatory state?

A

insulin resistance, hyerinsulinemia, hypertension, CAD, nonalcoholic fatty liver disease

23
Q

How does insulin resistance affect free IGF?

A

increases availability

24
Q

How does insulin resistance affect apoptosis?

A

decreases

25
Q

What is inflammation?

A

response of vascularized tissue to infection or injury

26
Q

What are the two types of inflammation?

A

acute and chronic

27
Q

Describe acute inflammation.

A

initial rapid response to infection/tissue damage
increased blood flow
increased vascular permeability
emigration of primarily neutrophils to site
phagocytosis
results in healing by fibrosis, resolution, or progression to chronic inflammation

28
Q

Describe chronic inflammation.

A

prolonged inflammatory response
infiltration of mononuclear cells
tissue destruction
healing by connective tissue replacement and angiogenesis
cause by persistent infections, hypersensitivity diseases, and prolonged exposure to toxic agents