basic science Flashcards

1
Q

Describe the main cell of athero

A

Foam cells –> macrophages

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2
Q

stages of athero

A

fatty streaks–> foam cells within aorta—>lipid core free cholesterol esters—>

mature athoro plaqus –> fibrous cap is smooth mucle cells and collegens produced by them

Plaque mineralizes –> circulating osteoprogenitor cells find

hydroxyapotite crystals

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3
Q

athero why at bifurcations

A

nonlaminar flow lowering shear stress so adehsion can happen (less forces taing away)

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4
Q

glagovs remodeling concept

A

artery exands and lumen doesnt changes. –> limit in amount the overall artery can expand then plaqye impinges

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5
Q

ACH response

A

normal - mod vasodil

athero - vascocaonstriction –> the hallmark of endothelial dysfunction

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6
Q

endothelial independent (direct and metab) and endothelium dependent

A

independent

direct No donors

-NO gas

Na Nitroprrusside

NO donors req metabolism

-NTG

ISDN

amlnitrate

dependent

-ACH

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7
Q

what is the general process of acute plaque rupture

A

Thin cap fibroatherom (thrombogenic lipid rich core underneath it)–> the cap ruptures and exposes the core to blood which then forms a thrombus.

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8
Q

What is in the fibrous cap

A

sm cells making ecm (collagens and elastins)

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9
Q

infammatory calls in athero

A

key cell is macrophage that turn into foam cells

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10
Q

where do plaques tend to rupture

A

sholder region

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11
Q

3 triggers of plaque rupture

A
  1. emotional stress
  2. Physcial activity

sympathetic tone.

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12
Q

POBA response hyperplasia

stent

A

medial

stent-> neointimal hyperplasia

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13
Q

loss index

A

late loss/acute lumen gain

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14
Q

When does neointimal hyperplasia occur\\

  1. neointimal hyperplasia what is it?
A

mostly in first 6 months

  1. sm cells–> 3 maj
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15
Q

3 major predictors of ISR (pre des)

A

small stent size (esp 2.5)/MLD

DM

Length

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16
Q

how do drugs eluting stents get drug attached

  1. What determines tissue retention time of drug for DES
A

need a coating to bind drug.

usually not bare coating

2.hyrdophobic state - longer retention time bc of all the fatty tissues.

17
Q

which des stent had the quickes elution in welts chart

A

endeavor

18
Q

mtor inhibitors basic moa

A

inhibit cell proliferatoin

19
Q

SIRUS trial

A

Cypher (sirolimus)

TCT 2002 - ISR and In segment restenosis.

20
Q

SIRTAX trial

A

sirulimul superior to paclataxal

21
Q

DEBs

A

shown inferiority to DES in ISR (RIBS IV

22
Q

guideline comments on ISR

A

need dapt of course after intervention

RX with DES/BMS - usually go to this first if first line.

IVUS/OCT is reasoable for mechanism IIA

23
Q

NNT

A

1/ARR