Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RC Test 2 > B4.021 - Atherosclerosis > Flashcards

B4.021 - Atherosclerosis Flashcards

1
Q

what is atherosclerosis

A

lipid laden deposits in the intima of large and medium sized arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is atherosclerosis characterized by

A

linear growth and quantum progression, spatial predilection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is critical stenosis

A

when chronic occlusion significantly limits flow and demand begins to exceed supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when does critical stenosis occur

A

usually around 70% occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what preserves luminal diameter as the total circumference expands

A

outward remodeling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are cholesterol crystals

A

crystal like absences from where cholesterol used to be

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is looked at in an angiogram

A

lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is seen within the plaque here

A

cholsterol crystals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

describe the response to injury hypothesis

A

Chronic endothelial cell injury leads to accumulation of lipoproteins (LDL) in injured area. Modification of lesional lipoproteins by oxidation leads to adhesion and migration o fblood monocytes into lesion and transformation to foam cells. Platelets adhese and cytokines and growth factors cause migration of smooth muscle cells from media to intima then that produces extracellular matrix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

risk factors for atherosclerosis

A

age

gender

genetic influences

hyperlipidemia

hypertension

smoking

DM

other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is c reactive protein a marker for

A

inlammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

why are women less likeyl to get atherosclerosis earlier in life

A

estrogen is protective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

describe the structure of lipoproteins

A

within the surface: cholesterol, phospholipids

center: cholesteryl esters, triglycerides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the highest density lipoprotein

A

HDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the largest/least dense lipoproteins

A

chylomicrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the 2 major goals of lipoprotein metabolism

A
  1. transport TGs from intestine and liver to sites of utilization
  2. transport of cholesterol to peripheral tissues for membrane synthesis and steroid hormone production
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the main lipoprotein that transports TGs from intestine to liver

A

chylomicrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the main lipoprotein that transports cholesterol from liver to other tisseus

A

VLDL, LPL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the “good cholesterol”

A

HDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what does HDL do

A

reverse cholesterol transort

takes up cholesterol from extrahepatic sources, esterification by LCAT and transport by large HDL particles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how do cells regulate cholesterol content

A
  1. synthesis in the SER
  2. receptor mediated endocytosis of LDL
  3. efflux of cholesterol from plasma membranes to apo-A1/HDL
  4. intracellular cholesterol esterification via acetyl-CoA acetyltransferase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

clinical assessment of lipids

A

total cholesterol

TGs

LDL

HDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is cholestyramine

A

bile-acid binding resin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what does ezetimibe do

A

cholesterol absorption inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what do statins do

A

decrease LDL, HMG-CoA inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

who are statins indicated for

A

those with 10 yr cardiac risk >7.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is fenobritate

A

fibrate

inhibits PPAR-alpha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what does niacin do

A

decreases hepatic VLDL secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what can niacin cause as a side effect

A

intense flushing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

not being able to take statins is a risk factor for what

A

Future events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

how does aspirin work

A

inhibits thromboxane A2 by irreversible acetylating COX-1, this attenuates platelet activation

32
Q

how long does it take for aspirin to get out of your system

A

1 week bc it irreversibly binds

33
Q

if you have a life threatening issue youre taking aspirin for when do you stop taking it before surgery

A

you dont

34
Q

how is aspirin used for primary prevention of atherosclerosis

A

prevents events

doses >75 mg/day show clear reduction in mortality and cardiovascular events

35
Q

what are contraindicatinos for aspirin in pts with atherosclerosis

A

allergy

bleeding

36
Q

most common cause of aspirin intolerance

A

GI upset

37
Q

what are risk factors for atherosclerosis you can prevent/treat

A

HTN

Hyperlipidemia: use of statins

smoking cessation

DM and glucose intolerance

lifestyle

38
Q

how is CRP generated

A

in response to IL-1/6 pathway

39
Q

what is a biomarker

A

something that varies with disease, can be detected specifically and sensitiviely and is relatively cheap to test for

40
Q

how early can atherosclerosis be seen

A

2nd decade of life

41
Q

what is a xanthoma

A

when foam cells accumulate at site of vascular injury under the epithelium

42
Q

natural history of atherosclerosis

A

normal–> fatty streak –> fibrofatty plaque –> advanced/vulnerable plaque –>

  1. aneurysm/rupture
  2. occlusion by thrombus
  3. critical stenosis
43
Q

sites that have a predispostion to atherosclerosis

A

thoracic and abdominal aorta

coronary arteries

peripheral arteries

carotid arteries

44
Q

sites with natural protection form atherosclerosis

A

internal mammary (thoracic) artery

45
Q

which artery is used as a bypass conduite

A

internal mammary (throacic) artery

46
Q

where do plaques form usually in vessels

A

areas with low sheer stress

47
Q

where are aueurysms common

A

aorta

48
Q

where are aneurysms rare

A

coronary

peripheral

carotids

49
Q

where are plaque ruptures frequent

A

coronary

50
Q

where are occlusions common

A

coronary

peripheral

51
Q

where are occlusions rare

A

aorta

52
Q

where are occlusions uncommon

A

carotids

53
Q

where are embolisms uncommon

A

coronary

54
Q

where are embolisms common

A

aorta, peripheral, carotids

55
Q

where are dissections rare

A

coronary

peripheral

carotid

56
Q

who are coronary dissections seen in

A

nonathero females

57
Q

where are dissections common

A

aorta

58
Q

what is determinant of if a rupture is going to happen in atherosclerosis

A

thickness of fibrous cap

59
Q

what is ultrasound and virtual histology used for

A

visualizing TCFA and how likely a plaque is to burst

60
Q

what is optical coherence tomography

A

flush and clear a blood field to visualize fibrous caps in a vessel

61
Q

which imaging modality is used here

A

ultrasound and virtual histology

62
Q

what imaging modality is used here

A

optical coherence tomography

63
Q

what is depicted here

A

TCFA

cholesterol crystals

64
Q

what type of event does this represent

A

rupture

65
Q

what type of event does this depict

A

erosion

66
Q

what is virchows triad

A

3 primary factors contributing to pathogenesis of thrombosis

  1. injury to epithelium
  2. alterations in blood flow
  3. increased coagulability of blood
67
Q

what does this represent

A

lines of Zahn

alternating bands of fibrin with WBC and RBCs entrapped

healed thrombi over the years

68
Q

what can cause this

A

cholesterol emboli from aorta causing skin necroses

69
Q

what is this pathopneumonic for

A

cholestrol emboli from atherosclerosis

note the cholestrol crystals

70
Q

how does abdominal aortic aneurism present

A

abdominal mass, pay pulsate

risk of rupture directly related to size of aneurysm

71
Q

cutoff diameter for intervention in abdominal aortic aneurysm

A

5 cm

72
Q

what is this

A

aortic dissection

Cross section showing lumen compression due to hemoatoma in tunica media

73
Q

what is this

A

recanalized coronary artery post bypass

74
Q

treatment for MI

A

stent

75
Q

treatment for pts with persistent angina

A

Beta blockers

ACEI

calcium channel blockers

76
Q

optimal medical therapy for chronic treatment of coronary atherosclerosis

A

aspirin

statins

risk factor modification

RC Test 2 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions