Circulatory Disease

Question 1

What is thrombosis?

Answer 1

The formation of a blood clot during the coagulation cascade

Question 2

What is a thrombus?

Answer 2

A blood clot attached to a blood vessel wall

Question 3

What is an embolus?

Answer 3

A blood clot freely flowing through blood vessels

Question 4

What are the causes of thrombosis?

Answer 4

Virchow’s Triad: endothelial injury (triggers coagulation cascade), changes in blood flow and blood make up

Question 5

What normally lines blood vessels to prevent clot formation? Give an example

Answer 5

Antithrombotic factors. e.g. heparan sulphate

Question 6

What are the possible consequences of a thrombi?

Answer 6

Infection
Infarction and/or ischaemia
Increased vessel size
Emboli formation
Recanalisation/organisational changes to vessel
Smaller thrombi disintegration

Question 7

What are the three types of emboli?

Answer 7

Pulmonary
Systemic
Thromboembolism

Question 8

Where does a pulmonary embolism normally originate? Why does it occur?

Answer 8

Deep veins
Occurs due to changes in blood flow or immobility

Question 9

What is a saddle embolism? What is its outcome?

Answer 9

Pulmonary embolism blocking blood vessel divisions. Leads to massive pulmonary embolism and death.

Question 10

Where does systemic embolism most commonly originate from?

Answer 10

Heart

Question 11

What can a systemic embolism effect?

Answer 11

Brain
Heart
Intestine
Kidneys
Lower extremities

Question 12

What can cause a systemic embolism?

Answer 12

Atheroma
Infection
Fat
Gas
Air
Amniotic fluid
Tumour

Question 13

What are the risk factors for heart disease?

Answer 13

Smoking
Lack of exercise
Diabetes
Obesity
Age
Gender
Stress
High cholesterol
Hypertension

Question 14

What is ischaemia?

Answer 14

Lack of oxygen to tissue

Question 15

What is infarction?

Answer 15

Death of tissue due to lack of oxygen supply

Question 16

How can ischaemia and infarction be treated?

Answer 16

By-pass surgery
Thrombolytic drugs

Question 17

What is an aneurysm?

Answer 17

Thin/weak area in aorta causes bulge in vessel wall

Question 18

What are the risk factors for hypertension?

Answer 18

Smoking
Stress
Coffee
Increased intake of salt and alcohol
Cold environment

Question 19

What is a normal blood pressure?

Answer 19

120/80mmHg

Question 20

What is considered high blood pressure?

Answer 20

> 160/90mmHg

Question 21

What factors contribute to causing hypertension?

Answer 21

Cardiac output imbalance
Renal function imbalance
Sodium homeostasis imbalance
Peripheral resistance

Question 22

What are some outcomes of benign hypertension?

Answer 22

Kidneys affected
Increased vessel wall thickness

Question 23

What are some outcomes of malignant hypertension?

Answer 23

Lumen size becomes fixed
Brain, heart and kidneys affected
BP = >160/110mmHg
Increased number of smooth muscle cells, collagen, GAGs
Microaneurysms
Haemorrhage

Question 24

How long can an advanced lesion take to form?

Answer 24

20-30 years

Question 25

What’s the first stage of Atherosclerosis?

Answer 25

Fatty streaks form under endothelium in intima layer
Macrophages endocytose fat and become foam cells

Question 26

What’s the second stage of Atherosclerosis?

Answer 26

Intermediate lesion
Foam cells die, leaving fat behind
Smooth muscle cells form over fatty streak, forming fibrous cap

Question 27

What’s the third stage of Atherosclerosis?

Answer 27

Advanced lesion
Central core made up of fat and necrotic mass present
Fibrous cap made up of smooth muscle cells, collagen and macrophages present
Bulges into lumen