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Cardiovascular Risk Factors Flashcards

1
Q

Name a progressive disease that is characterised by a buildup of plaque within the arteries?

A

Atherosclerosis

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2
Q

What 5 substances form plaque?

A
  1. Fatty substances
  2. Cholesterol
  3. Cellular waste
  4. Calcium
  5. Fibrin
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3
Q

What two things can happen to a plaque (atherosclerosis) and what does that lead to?

A
  1. Bleeding into the plaque
  2. Formation of a clot on the surface of the plaque

Heart attack or stroke

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4
Q

What is the term used to describe the formation of an acute thrombus in a vessel affected by atherosclerosis, a process common to a number of CV disorders?

A

Atherothrombus

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5
Q

What is the atherothrombotic process initiated by?

A

Changes in vessel wall resulting from plaque disruption

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6
Q

What components can the atherosclerotic plaque expose when it becomes unstable and ruptures?

A

Collagen and von Willebrand factor

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7
Q

What two substances allow platelets to adhere to the damaged area and initiate thrombus formation?

A

Collagen

Von Willebrand factor

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8
Q

What can a thrombus extending and occluding the vessel lead to?

A

Acute ischaemia and tissue injury

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9
Q

What is the term for thrombosis superimposed on atherosclerosis?

A

Atherothrombosis

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10
Q

What three conditions can result if there is a fibrous plaque, atherosclerotic plaque?

A
  1. Angina
  2. Transient ischaemic attack
  3. Claudication/PAD
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11
Q

What might cause ischaemia in distal vascular beds?

A

Embolisation of platelets or fibrinous material from ulcerated plaques

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12
Q

What are the clinical effects of atheroma in retinal arteries?

A

Imparied vision

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13
Q

What are the two clinical effects of atheroma in renal arteries?

A

Hypertension and renal failure

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14
Q

What are the clinical effects of atheroma in mesenteric arteries?

A

Mesenteric ischaemia

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15
Q

What are the two clinical effects of atheroma in femoral arteries?

A

Claudication

Gangrene

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16
Q

What are the two clinical effects of atheroma in aorta/iliac arteries?

A

Intermittent claudication

Gangrene

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17
Q

What are the clinical effects of atheroma in coronary arteries?

A

Ischaemic heart disease

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18
Q

What are the two effects of clinical atheromas in the cerebral/carotid arteries?

A

Transient ischaemic attack

Strokes

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19
Q

In the pathogenesis of atherosclerotic plaques: what protective response results after endothelial damage?

A

Production of cellular adhesion molecules

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20
Q

What can these factors all potentially cause - hypertension, vasoactive substances, mediators (cytokines) from blood cells, cigarette smoke, atherogenic diet, elevated glucose levels and oxidised LDL-C?

A

Damage to endothelium of arterial walls resulting in endothelial dysfuncion

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21
Q

Name two cytokines expressed by endothelila cells after vessel damage?

A
  1. IL-1

2. TNFalpha

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22
Q

What three chemokines are expressed by endothelial cells after damage to vessel walls?

A
  1. Monocyte chemoattractant factor
  2. MCP-1
  3. IL-8
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23
Q

What two growth factors are expressed by endothelial cells as a result of vessel damage?

A
  1. Platelet-derived growth factor PDGF

2. Basic fibroblast growth factor BFGF

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24
Q

What is decreased by endothelial cells, as a response to oxidative stress in the vessel wall?

A

Production of NO, a vasodilator

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25
What two substances are increased by endothelial cells, as a result of opxidative stress in the vessel wall?
Endothelin | Angiotensin II
26
What two local mediators are increased by endothelial cells, as a result of oxidative stress on the vessel wall?
1. Vascular cell adhesion molecule (VCAM) | 2. Plasminogen activator inhibitor 1 (PAI-1)
27
What are the levels of HDL, LDL and triglycerides in dyslipidaemia?
HDL is low LDL is high Triglycerides are high
28
What are the big 4 CV risk factors?
1. High blood pressure 2. Hypercholesterolaemia 3. Smoking 4. Diabetes/obesity
29
Are VLDL and Chylomicrons atherogenic?
No
30
What carries cholesterol away from the arterial wall and is protective?
HDL
31
Which lipoproteins are the lowest in density, and biggest in size?
Chylomicrons
32
What lipoproteins are involved in the recycling of cholesterol by the liver as well as formation of LDL in blood?
IDL - intermediate-density lipoprotein
33
Which lipoprotein is strongly associated with atherosclerosis?
LDL
34
What is the normal triglyceride level and what does high triglyceride increase the risk of?
2.3 mmol/l | Pancreatitis
35
What is the exogenous metabolic pathway concerned with?
The transport and utilisation of dietary fats
36
What is the analogous particle that transports triglycerides from the liver to the rest of the body?
VLDL
37
During what process are triglycerides removed from the core and exchanged for cholesterol esters, prinipally from HDL?
Endogenous pathway of lipid metabolism
38
Is total cholesterol a modifiable risk factor?
Yes
39
What is the primary target (cholesterol) to prevent CHD?
LDL-C
40
What is xanthelasma a clinical marker for?
Dyslipidaemia
41
What are tendon xanthomas?
Diffuse infiltration of tendon by lipid
42
What are tuberous xanthomas?
Lipid deposits in the dermis and subcutis; papuler, nodular or plaques; extensor surfaces of large joints, hands, buttocks, heels and flexures
43
What two things can tuberous xanthomas be a sign of?
1. Familial or acquired hypertriglycerdemias | 2. Biliary cirrhosis
44
What are eruptive xanthomas, and what do they indicate?
Small reddish/yellow papules found on buttocks, posterior thighs and body folds Usually abrupt increase in serum triglyceride levels
45
What sign of dyslipidaemia can you find on palms?
Striate palmar xanthomas
46
What are the two types of hypertension?
1. Essential - no underlying cause | 2. Secondary - underlying cause
47
What 5 substances can be included to diet to reduce obesity and CHD?
1. Micronutrients 2. Antioxidants 3. Omega 3 and 6 4. Polyuinsaturates 5. Monounsaturates
48
What type of diet protects against CHD and is rich in fruits, vegetables, fish, grains and beans?
Mediterranean
49
To achieve a diagnosis of metabolic syndrome, what characteristics msut a patient have 3 or more of (include values)?
1. Abdominal obesity 2. Triglycerides : > 1.7 mmol/l 3. HDL-C : 130/>85 mmHg 5. Fasting glucose : >5.6 mmol/l
50
What may homocysteine undergo remethylation to form, and what two substances does this process require?
Methionine | B12 and folic acid
51
What is used to assess a patients CV risk score?
Assign score
52
What is the most common cause of premature death?
Coronary heart disease
53
What are stenosis, thrombosis, aneurysm, dissection, embolism and ischaemia all complications of?
Atheroma
54
What involves narrowing of the arterial lumen, reduced elasticity, reduced flow in systole and tissue ischaemia?
Arterial stenosis
55
What leads to reduced exercise tolerance, angina, unstable angina, infarct and cardiac failure?
Cardiac ischaemia
56
Give 4 features of cardiac fibrosis?
1. Loss of cardiac myocytes 2. Replacement by fibrous tissue 3. Loss of contracility 4. Reduced elasticity and filling
57
What 4 arteries are mainly affected by arterial stenosis?
1. Coronary arteries 2. Carotid arteries 3. Renal arteries 4. Peripheral arteries
58
What are 3 results of arterial stenosis in the carotid arteries?
1. Transient ischaemic attack 2. Stroke 3. Renal failure
59
What are two results of arterial stenosis in renal arteries?
1. Renal failure | 2. Hypertension
60
What are two results of arterial stenosis in peripheral arteries?
1. Claudication | 2. Foot/leg ischaemia
61
What does plaque rupture often trigger?
Thrombosis
62
What can cause MI, cerebral infarction, renal infarction and bowel infarction?
Arterial thrombosis
63
What are the 4 features in aneurysm formation?
1. Annormal dilatation of artery 2. Weakening of media by atherosclerosis 3. Elastic degeneration and fragmentation-loss of stretch/recoil 4. Abdominal aorta
64
What are these causes of - congenital, berry aneurysm and subarachnoid haemorrhage, syphylitic, mycotic and iatrogenic?
Abnormal dilatation of artery
65
What are 3 complications of aneurysm?
1. Rupture 2. Thrombosis 3. Embolism
66
What are three features of arterial dissection?
1. Splitting within the media by following blood 2. False lumen filled with blood within the media 3. Sudden collapse
67
What is likely to occur in middle aged patients with/without atheroma?
Arterial dissection
68
What are these potential causes of - atheroma, hypertension, trauma, coarctation, marfan's and pregnancy?
Aortic dissection

JL Cardiovascular (18 decks)

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