Cardiovascular pathophysiology Flashcards
CVD is one of Australia’s largest health problems
– It accounts for 25% of all deaths
– Kills ???% more males than females
40%
CVD kills 118 people every day
– Every ??? minutes someone dies from CVD
12
TRUE or FALSE: Someone is hospitalised for CVD every minute
– 1619 people per day, every day of the year
TRUE
what disease in Australia is the largest costs of any disease?
CVD = heart, stroke, and vascular diseases
???% of Australians are at risk of CVD
75%
– CHD is disease of the coronary arteries i.e. ??? and also known as ischaemic heart disease, or heart
disease
atherosclerosis
TRUE or FALSE: CHD is the most common form of CVD
TRUE
what are the 2 clinical forms of CHD?
angina & heart attack
Atherosclerosis - changes in ??? layer of arteries consisting of the focal accumulation of lipids, other
blood constituents and fibrous tissue, accompanied by changes in the media of the vessel wall
intima layer
atherosclerosis is the result of the interaction between:
- Components of the blood (atherogenic lipoproteins)
– ??? forces (high blood pressure)
Haemodynamic
TRUE or FALSE: Atherosclerosis progresses throughout life. Plasma lipid levels increase as we get older
TRUE
Males have higher TG and lower HDL-C than females as Oestrogen increases the LDL receptor activity
an the synthesis of Apo A-I. Therefore, oestrogens lowers or raises (?) LDL-C and raise HDL-C
lowers
Which lipoproteins increase our risk for CHD?
IDL, LDL, sdLDL and chylomicron remnants
Systolic blood pressure – rhythmic ejection of blood into the aorta or vena cava (?) from the heart
aorta
Systolic or diastolic (?)blood pressure Indicates how much pressure your blood is exerting against your artery walls when the heart beats?
systolic
Diastolic blood pressure – the minimum level of blood pressure measured between ??? of the heart
contractions
Systolic or diastolic (?) indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats and increases mainly when
resistance of the arterioles (main contributor)
diastolic
Smoking impairs lipolysis of VLDL and thereby prevents the postprandial rise in ???
HDL-C
The Mediterranean diet has been shown to reduce death from myocardial infarction, stroke and
other vascular diseases by ???% compared to a low fat diet
30%
what is Extremely important for neurological development?
omega 3 PUFAs
TRUE or FALSE: Omega-3 lowers plasma triglycerides and BP, Reduces cardiac arrhythmia and cardiac death
TRUE
TRUE or FALSE: trans fatty acids from ruminant sources are not ok, just like industrial
FALSE they are ok to eat
Saturated fat increases LDL-C & HDL-C (but not dietary ???)
cholesterol
Uncontrolled hypertension - LVH: Produces increased demands on the heart = left ventricular hypertrophy and heart failure. Increased demands on the vessels of the arterial system= ???, kidney disease and stroke
atherosclerosis
big risk factors for CHD are: smoking, BP, and ???
age
Two factors which have a major bearing on the occurrence of atherosclerosis are raised plasma lipids & ???
hypertension
LDL- apo B & atherosclerosis (but LDL-C is normal):
- sdLDL particles penetrate arterial wall more easily than large LDL particles and become more easily ???
oxidized
IDL and chylomicron remnants, if elevated in the blood stream, they can also deposit cholesterol in the arterial wall = ???
atherosclerosis
most deaths from CHD occurs after
age ??? (men) and age 75 (women)
65
Which plaques are more likely to rupture?
Ones that have greater number of ??? and lower tensile
strength and fewer smc in the cap
macrophages
which one of the following for Oxidised LDL causes stiffening of arterial walls:
- is rapidly taken up by macrophages
- chemotactic for monocytes & inhibits macrophage motility
- cytotoxic
- alter gene expression of endothelial cells to express MCP-1
- increase expression of adhesion molecules to endothelial cells
- inhibits endothelial dependent relaxation
- exhibits increasing binding to type I collagen
- inhibits endothelial dependent relaxation
- exhibits increasing binding to type I collagen
for regression of atherosclerosis, need to lower or increase plasma cholesterol?
lower
are the following cholesterl or TG lowering?
- Bile acid sequestrants (cholestyramine, colestipol)
- HMG-CoA reductase inhibitors (statins)
- Ezetimibe
- Nicotinic acid (Niacin)
Cholesterol lowering:
Are the following cholesterol or triglyceride lowering?
- Fibric acid derivatives (e.g. gemfibrozil)
- Nicotinic acid (Niacin)
- Omega-3 fatty acids (EPA/DHA)
TG lowering
Bile acid sequestrants: Non adsorbable anion exchange binding resin that forms insoluble complex with ??? and interrupts enterohepatic recirculation of bile
acids
bile acids
statins: Competitively inhibits HMG-CoA reductase, lower cholesterol synthesis, lower or increase (?) hepatic LDL receptor synthesis to promote clearance of LDL and IDL
increase
Ezetimibe is used when ??? are not so effective, & used in addition to them. works by inhibiting cholesterol
absorption in the GI tract
= Less cholesterol to liver
= Liver upregulates LDL receptor
= Reduce circulating LDL-C
statins
Nicotinic acid: Inhibits fatty acid mobilisation from adipose tissue and inhibits VLDL synthesis = inhibits ??? synthesis
LDL
the common side effects of which drug only effects the GI tract?
Bile acid sequestrants
which drug causes side effects (rare) that include muscle weakness, Loss of sensation or tingling in nerve endings (peripheral neuropathy) and Tendon problems?
statins
