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Sem 2 > cholesterol, atheroma, CHD > Flashcards

cholesterol, atheroma, CHD Flashcards

1
Q

LDL levels are raised by (3)

A

cigarette smoking, coffee, stress

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2
Q

Majority of cholesterol is

A

LDL

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3
Q

Cholesterol largely responsible for atheroma formation

A

LDL

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4
Q

Cholesterol which prevents atheroma

A

HDL

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5
Q

Functions of cholesterol (6)

A

lipid precursor for other steroids, important in cell growth and division, regulation of sexual function, regulation of tissue metabolism, mineral balance and formation of bile salts

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6
Q

proportion of cholesterol made in liver

A

1/4

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7
Q

cholesterol is poorly absorbed by

A

gut

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8
Q

cholesterol is carried in blood as part of

A

lipoprotein

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9
Q

HDL formation begins in

A

liver

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10
Q

HDL begins as

A

empty collapsed protein shell

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11
Q

HDLs travel in blood picking up

A

cholesterol and phospholipids

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12
Q

After picking up cholesterol and phospholipids, HDL

A

returns to liver and cholesterol is removed

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13
Q

chylomicrons form in

A

absorptive cells of small intestine

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14
Q

chylomicrons travel from small intestine through ….. to blood

A

lymphatic system

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15
Q

chylomicrons are hydrolysed to monoglycerides and free fatty acids to travel through capillary walls into adipocytes before being resynthesised into

A

triglycerides

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16
Q

VLDLs are produced by

A

liver

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17
Q

VLDLs transport lipids to adipose tissue for storage where they become

A

LDLs

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18
Q

liver compensates for …………. of cholesterol

A

dietary intake

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19
Q

changes in diet can reduce serum cholesterol by

A

5% max

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20
Q

Fatty acid intake can reduce cholesterol level by

A

15-20%

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21
Q

2 other forms of synthesis of cholesterol

A

glycolysis (acetyl CoA) or beta-oxidation of other lipids

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22
Q

exercise reduces sensitivity of right atrium to …….. and so heart secretes less …… and blood volume …… meaning more cholesterol is transported by HDLs to …….

A

blood pressure; atrial natriuretic peptide; increases; liver

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23
Q

familial hypercholesterolaemia due to (2)

A

low number LDL receptors, altered function/structure of receptors

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24
Q

familial hypercholesterolaemia is most common type of ……… (1/500)

A

hyperlipidaemia

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25
Q

in familial hypercholesterolaemia, LDL levels are in excess of

A

190

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26
Q

LDL receptor gene on chromosome

A

19

27
Q

familial hypercholesterolaemia alleles exhibit

A

incomplete dominance

28
Q

symptoms of familial hypercholesterolaemia (5)

A

xanthomas, xanthelasmas, arcus senilis, obesity, symptoms of atherosclerosis

29
Q

xanthoma =

A

fatty, cholesterol-rich deposits in skin

30
Q

xanthelasma =

A

fatty deposits on eyelid

31
Q

arcus senilis =

A

white ring around cornea

32
Q

atheroma =

A

accumulation of intracellular and extracellular lipid in INTIMA of large and medium arteries

33
Q

3 stages of atheroma formation

A

fatty streak, simple plaque, complicated plaque

34
Q

arteriosclerosis =

A

thickening of arterial walls, usually due to diabetes / hypertension

35
Q

causes of atherosclerosis (5)

A

high BP, high cholesterol, smoking, high blood sugar, heart disease - angina

36
Q

risk factors of atherosclerosis (15)

A

smoking, male, menopause, diet, alcohol, obesity, familial hyperlipidaemia, acquired hyperlipidaemia, diabetes, lack of exercise, type A personality, stress, infection, soft water, oral contraceptives

37
Q

ATHEROMA FORMATION: (1) micelles absorbed into intestinal mucosa > converted to ……

A

chylomicrons

38
Q

ATHEROMA FORMATION: (2) chylomicrons absorbed by ……… and travel through thoracic duct to be distributed throughout the body

A

lacteals

39
Q

ATHEROMA FORMATION: (3) ………… ………. hydrolyses chylomicrons into fatty acids and monoglycerides which are released into intestinal fluid to be absorbed by adipocytes and skleletal muscle

A

lipoprotein lipase

40
Q

ATHEROMA FORMATION: (4) liver absorbs chylomicron and removes triglyceride > combines with ……….. (alters surface protein)

A

cholesterol

41
Q

ATHEROMA FORMATION: (5) Capillary endothelial cells contain LDL receptors and absorb LDLs in ………. coated vesicles

A

clathrin

42
Q

ATHEROMA FORMATION: (6) Excess levels of cholesterol inhibit cholesterol and LDL receptor synthesis > LDL uptake reduced > cholesterol ……… promoted

A

storage

43
Q

ATHEROMA FORMATION: (7) Circulatory monocytes remove ………. and become saturated with ………… droplets

A

lipoproteins; lipid

44
Q

ATHEROMA FORMATION: (8) Saturated monocytes form ….. cells which attach to endothelial walls of blood vessels

A

foam

45
Q

ATHEROMA FORMATION: (9) Once foam cells attached to endothelial walls of blood vessels, they release cytokines which stimulate stimulate smooth muscle cells near the tunica ………… to divide causing the walls to thicken

A

intima

46
Q

ATHEROMA FORMATION: (10) Other monocytes invade the area and ……….. lipids forming an atherosclerotic ……. and ……..

A

phagocytise; plaque; stenosis

47
Q

LDLs secrete ……. which prevents normal migration of macrophages out of arteries

A

netrin-I

48
Q

coronary atherosclerosis is a complex …….. process

A

inflammatory

49
Q

coronary atherosclerosis is the accumulation of lipids, macrophages and …… ……… cells

A

smooth muscle

50
Q

ATHEROGENESIS: (1) atherogenesis follows endothelial …….. with increased permeability to and accumulation of ………. lipoproteins

A

dysfunction; oxidised

51
Q

ATHEROGENESIS: (2) oxidised lipoproteins taken up by macrophages at ………. ….. within endothelium

A

focal sites

52
Q

ATHEROGENESIS: (3) these macrophages form lipid-laden ….. …… which form a fatty …..

A

foam cells; streak

53
Q

ATHEROGENESIS: (4) fatty streak progresses with extracellular lipid within endothelium to form a ………… plaque

A

transitional

54
Q

ATHEROGENESIS: (5) monocytes, macrophages and damaged endothelium release ….. which promote further accumulation of macrophages and smooth muscle cell migration and ……….

A

cytokines; proliferation

55
Q

ATHEROGENESIS: (6) collagen is produced in large quantities by ……… ………. and events accumulate finally forming a ……… ……..

A

smooth muscle; fibrolipid plaque

56
Q

There are two mechanisms a thrombosis can develop on a plaque:

A

superficial endothelial injury, deep endothelial fissuring

57
Q

superficial endothelial injury = denudation of endothelial covering of plaque exposing the subendocardial …. ……. ………. and allowing platelet adhesion due to reaction with …..

A

connective tissue matrix; collagen

58
Q

deep endothelial fissuring = advanced plaque with ….. core formed because plaque cap tears allowing …. to enter. Core now has lamellar lipid surfaces, …… …… produced by macrophages and exposed ….. which makes it highly …..

A

lipid; blood; tissue factor; collagen; thrombogenic

59
Q

total cholesterol ratio should not exceed

A

5

60
Q

ideal cholesterol ratio

A

1.0-3.5

61
Q

when calculating cardiovascular risk, what is cut off for high risk?

A

20+%

62
Q

when calculating cardiovascular risk, what is cut off for moderate risk?

A

10-20%

63
Q

when calculating cardiovascular risk, what is cut off for low risk?

A

<10%

Sem 2 (11 decks)

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