Circulatory Disorders

Question 1

What is a vascular occlusion?

Answer 1

Blockage of a blood vessel

Question 2

What can a vascular occlusion result from?

Answer 2

• Thrombosis
• Embolism
• Atherosclerosis
• External compression

Question 3

What does the severity of a vascular occlusion depend on?

Answer 3

• Type of tissue involved
• How quickly the occlusion occurs
• Availability of collateral circulation

Question 4

What is a thrombus?

Answer 4

Solid mass of blood formed within the cardiovascular system involving; endothelial cells, platelets and coagulation cascade

Question 5

What are some differences between patients suffering from arterial and a venous thrombus?

Answer 5

ARTERIAL:Old age, circulatory disorders, diabetic, smoker
VENOUS: may be any age, immobility (i.e. flights)

Question 6

Name for the factors contributing to thrombus

Answer 6

Virchow’s triad

Question 7

What are the factors that make up Virchow’s triad?

Answer 7

1. Alteration to blood constituents
2. Damage to endothelial lining
3. Changes to normal blood flow

Question 8

What is an embolism?

Answer 8

Where fragments of thrombus break off and travel through blood and cause an occlusion elsewhere

Question 9

What are the lines of Zahn?

Answer 9

Alternating red and white blood cell deposits, operated along blood flow

Question 10

Treatments for thrombus

Answer 10

Streptokinase

Aspirin

Question 11

What is the mechanism of streptokinase?

Answer 11

Promotes formation of plasmin which breaks down the clot

Question 12

What is the mechanism of aspirin?

Answer 12

Inhibits thromboxane thus inhibiting clot formation

Question 13

What is atherosclerosis?

Answer 13

Damage to intima which causes narrow vessels and obstruction

Question 14

What is arteriosclerosis?

Answer 14

Disease of media –> increased wall thickness and decreases elasticity –> hypertension

Question 15

Main difference between atherosclerosis and arteriosclerosis

Answer 15

Atherosclerosis is a disease of the intima

Arteriosclerosis is a disease of the media

Question 16

Where do plaques form?

Answer 16

Atheromatous plaques form in the intima of the artery

Question 17

What kind of core do atheromatous plaques have?

Answer 17

Necrotic cores

Question 18

What are the major components of atheromatous plaques?

Answer 18

• Cells
• ECM
• Lipid
• Calcification

Question 19

Processes in plaque formation

Answer 19

Intimal thickening

Lipid accumulation

Question 20

What is the name for coronary artery disease?

Answer 20

Ischaemic heart disease

Question 21

What is a prominent feature of ischaemic heart disease?

Answer 21

Sudden death

Question 22

Fixed risk factors of CAD

Answer 22

Age, males, positive family history

Question 23

Modifiable risk factors of CAD

Answer 23

Smoking, obesity, diabetes, hypertension

Question 24

3 causes of restricted blood supply to the heart

Answer 24

1. Blockage
2. Decrease in oxygenated flow
3. Increased demand

Question 25

Why may someone have an increased demand to the heart?

Answer 25

Increased cardiac output or they have have hypertrophy (enlarged heart)

Question 26

Why may someone have a decrease in deoxygenated blood flow?

Answer 26

Anaemia, CO poisoning, hypotension

Question 27

What is arteriogenesis?

Answer 27

Collateral vessel formation so that if an artery is occluded then blood can be diverted from other arteries to compensate

Question 28

Treatments for an artery blockage?

Answer 28

Angioplasty

Stents

Question 29

What is angioplasty?

Answer 29

When deflated ballon is then inflated in artery to squash the plaque flat

Question 30

What is restenosis?

Answer 30

When after stenting, the blockage reforms over a period of time

Question 31

What else can be done to stents to reduce blockages?

Answer 31

Drug elution from stints

Question 32

What are some risks associated with stenting?

Answer 32

May not be safe long term and increased late stent thrombosis