Blood Vessel Pathology - Bikman Flashcards
What are the general steps in getting atherosclerosis?
Injury, monocyte adhesion and migration, macrophage activation, leukocytes and smooth muscle cells engulf lipids, collagen and lipid deposition
What are risk factors for atherosclerosis?
Non-modifiable - age, gender, genetics
Modifiable- lifestyle, cigarette smoking, diabetes, inflammation
What are other complications of atherosclerosis?
Aneurism, thrombosis, embolus, calcification, stenosis, calcification
What are the two types of cholesterol patterns?
Type A- less dense and larger
Type B- dense and small
Which of the two cholesterol patterns is worse?
Type B
Think of the tennis ball and golf ball scenario
What are risk factors for Type B pattern cholesterol?
Genetics, oral contraceptive, diet
Can you measure LDL B? If so, how?
Can be measured in size but usually that is not how it is tested.
Can use the triglyceride:HDL
Less than a 1.5 ratio is good
Is LDL B with no modifications bad?
No; it needs to be oxidized by a free radical such as ROS to cause foam cells
What are the effects of glucagon and insulin on cholesterol?
Glucagon- decreases cholesterol
Insulin- increases cholesterol and absorption of cholesterol in the intestines
What do statins do?
They inhibit HMG-CoA reductase which produces cholesterol
What are the side effects of statins?
Increases risk of diabetes
Kidney failure
Liver failure
Muscle failure (rhabdomyolysis) - decreased ubiquinone decreases the mitochondria
What is an alternative to statins?
Asprin- cheaper and less side effects
What are the functions of cholesterol?
Cell membrane fluidity Steroid synthesis Ubiquinone Bile Salts Vitamin D
Hypertension and the two types
Having blood pressure 140/90
Asymptomatic
Benign-primary (no reason), secondary (from a defect ie.renal defect)
Malignant-lethal within 1-2 years and usually accompanied by renal failure, retinal hemmorrages, papilledema
What is the main benefactor to hypertension?
Insulin resistance
What are the other primary benefactors to hypertension?
RAAS dysfunction, enhanced GF activity, SNS (sympathetic nervous system) dysfunction, dyslipidemia, decrease in nitric oxide
True or False: Salt is the main proponent in hypertension
False, mostly genetic, but also has to do with lipid and weight gain
What are the two types of aneurysms?
True- all the walls of the vessel are distended
False- one layer broken and blood pooling
How can you cause aneurysms?
arterosclerosis, marfans syndrome, trauma, congenital defects, infections
What are the types of aortic dissection?
aortic wall tears and blood pouring into the walls
Type 1A- ascending aorta and distal ends
Type 2A- ascending aorta only
Type B- descending aorta
“false aneurysm”
What is vasculitits?
Inflammation of blood vessel
Giant cell arteritis
Vasculitis
Inflammation of large to small blood vessels in the head
Most common
Treatment: corticosteroids
Takayasu arteritis
Vasculitis Severe narrowing of major arches off the aortic arch Weak pulse Ocular disturbences "pulselessness" disease
Polyarteritis nodosa
Vasculitis
Death of blood vessels from scarring
Fatal if untreated
Necrotizing vasculitis
Wegener gramulomatosis
Vasculitis Triad of symptoms: renal disease, vasculitis, ANCA positive More common in over 40 yrs Fatal if untreated Granulomas in the lungs Similar to Churg-Strauss Syndrome
Churg-Strauss Syndrome
Vasculitis
Similar to Wegeners granulomatosis
Vasculitis in the lungs
Microscopic Angititis
Vasculitis of smaller vessels
Antibody response to drug or bug
Possibly type 3 hypersensitivity
Removing the offending agent usually resolves the problem
Hemanginoma
Benign Blood vessel tumor
Different kinds: capillary, cavernous, pyogenic
Glomus Tumor
Affects nails
Benign but painful
Kaposi Sarcoma
Low grade malignancy
Affects different cultures differently (Jewish males and Africans)
AIDS and transplant associated
Angiosarcoma
Malignant
Fatal
Can get from being exposed to arsenic
