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PATHOphys Exam 2 > Cardiac 2 Shea > Flashcards

Cardiac 2 Shea Flashcards

1
Q

Take up the released lipids and cell remnants from dying or injured smooth muscle cells

A

The role of macrophages in athrogenesis

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2
Q

What 3 things do macrophages secrete? What happens?

A
  • Cytokines
  • TNF
  • other biologically active substances

Which cause more damage by stimulating collagen production (from fibroblasts), along w/ smooth muscle cells

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3
Q

The repair of the initial arterial lesion involves what?

A

Scarring due to collagen deposition (leads to hardening or sclerosis)

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4
Q

In atherosclerosis, what is the name of the bulge?

A

Atheroma

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5
Q

Prototype lesion which bulges into the lumen of the artery

A

Atheroma

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6
Q
  • The central part of an atheroma is soft and consists of what 2 things?
  • What is the soft core covered by?
A
  • lipids
  • cellular debris
  • Covered by fibrous tissue (forms fibrous/surface cap)
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7
Q

What is the “cellular debris” inside the atheroma?

A

Macrophages (filled w/ LDL, VLDL)

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8
Q
  • smooth muscle cells
  • macrophages
  • foam cells
  • lymphocytes
  • collagen
  • elastin
  • proteoglycans
  • neovascularization
A

Fibrous Cap of atheroma

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9
Q
  • cell debris
  • cholesterol crystals
  • foam cells
  • calcium
A

Necrotic center of atheroma

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10
Q

What is the major complication of the atheroma?

A

Hardening of the vessel from calcification (precipitated by local tissue degeneration)

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11
Q

What causes attraction of Ca salts of an atheroma which can be seen on x-rays as a radiodense material?

A

Lipids released from dead cells and abnormal celluar matrix

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12
Q

What are the 2 main risk factors of atherosclerosis?

A
  • Age (older people)
  • Sex (affects more men by 2x)
    • women have estrogens which have a “protecting effect”
    • women after menopause who take HRT will continue to have the protecting effect
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13
Q

What are the 7 other risk factors for atherosclerosis besides 1. old age and 2. male sex?

A
  1. Heredity
  2. Lipid metabolism
  3. HTN
  4. Obesity
  5. DM
  6. Cigarette smoking
  7. Stress
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14
Q

A genetic defect of LDL receptors, which does not allow lipoproteins into the liver, causes atherosclerosis at an EARLY AGE, best known cause for familial atherosclerosis.

A

Familial Hypercholesterolemia

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15
Q

How do you modify a genetic predisposition to atherosclerosis? (familal hypercholesterolemia)

A

Healthy lifestyle and balanced diet

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16
Q

Risk factor of Atherosclerosis : Lipid Metabolism

Serum Cholesterol Levels exceeding ____ mg/dL increases the risk 5 X as compared to levels less than _____ mg/d: (normal range)

A

Exceeding 260

Less than 200 (normal)

17
Q

Blood compressing the intimal cells making them ischemic or stimulating them to release cytokines which promote proliferation of smooth muscle cells.

A

A possible explanation of HTN causing atherosclerosis

18
Q

What causes changes to clotting system by damaging platelets, causing aggregation and release of biogenic substances from their cytoplasm (over-activated makes them sticky)

A

HTN

19
Q
  • Causes a secondary hyperlipidemia
  • Tissue fat is in equilibrium w/ circulating lipids
  • Increased total body fat leads to hyperlipidemia
  • Develop atherosclerosis at earlier age w/ more pronounced lesions compared to other patients
A

Obesity

20
Q
  • ____ Alters metabolism of basement membranes and damages SMALL blood vessels of the glomerular capillaries and larger renal arterioles
  • _____ Accelerates atherosclerosis in larger arteries (coronaries, cerebral, aortic)
A
  • Hyperglycemia alters basement membranes
  • Diabetes accelerates atherosclerosis
21
Q

What is the #1 organ killed from DM?

A

Kidneys, most people on wait list for kidney transplant are DM patients.

22
Q

How does cigarette smoking contribute to atherosclerosis?

A

Not fully understood…, but they do cause vasoconstriction.

23
Q

How does stress contribute to atherosclerosis?

A

CONSTANT stress may accelerate/aggravate atherosclerosis

24
Q
  • A very common finding in older men and almost all persons over 50
  • Lesions vary from mild –> severe, may be focal or diffuse
A

Atherosclerosis of the Aorta

25
Q
  • Mildest forms of ___ are found in young or middle aged persons
  • These people have fatty streaks, slightly raised fibrotic plaques
A

Atherosclerosis of Aorta

26
Q

Atherosclerosis of Aorta

  • Do fatty streaks progress to atheromas?
A

Yes, as it progresses, atheromas form (lipid rich/bulging lesion)

27
Q

In the final stages of atherosclerosis, this vessel is rigid, calcified tube w/ rough/jagged/ulcerated internal surface covered focally w/ thrombi.

A

Aorta

28
Q

Is BP affected by atherosclerosis?

A

Yes, the aorta cannot expand during systole, so HTN develops. The pressure causes dilatation of the inelastic aorta which leads to formation of aneurysms.

29
Q

Where do atherosclerotic aneurysms of the aorta occur most commonly?

A

abdominal aorta, are usually clinically silet and discovered by accident during exam

30
Q

Are most often fusiform, saccular, or spindle-shaped

A

Atherosclerotic Aneurysms of Aorta

31
Q

Small saccular aneurysms at base of brain

A

Berry Aneurysm

32
Q

What is the “spindle shaped” aneurysm?

A

Dissecting aneurysm

33
Q

String sign is associated w/ what?

A

AAA, tons of plaque

34
Q

What is the major danger of any aneurysm?

A

Rupture and death by exsanguination (jet of blood may dissect through wall of aorta forming a periarterial 2nd lumen = dissecting aneurysm)

35
Q

Aneurysms can be resected surgically and replaced by an artificial vessel made of Dacron or Gortex material. Which one is better and why?

A

Gortex, is stretches.

36
Q
  • Most common location is 1 inch above dissesction
  • 85% uncontrolled HTN
  • 15% Marfans
  • Blood goes underneath, separates entire wall w/ half of media on either side of blood
  • 100% mortality
A

Aortic Root Dissection

37
Q

Reversible, unless calcified

A

Atheromas

38
Q

Aortic Dissection can lead to what?

A

Hemopericardium, which may lead to cardiac tamponade

39
Q
A

PATHOphys Exam 2 (22 decks)

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