circulatory disorders

Question 1

CV disorders contribute to __% of all male deaths in the UK in 2014

Answer 1

28

Question 2

cost __billion per year with direct health care costs at £__billion

Answer 2

19,

9

Question 3

vascular or arterial occlusion =

Answer 3

blockage

Question 4

vascular occlusion results from:

Answer 4

→ thrombus
→ embolism
→ atherosclerosis
→ compression

Question 5

what do the consequences of occlusions depend on?

Answer 5

→ type of tissue → artery or vein
→ speed at which occlusion occurs
→ availability of collateral circulation (e.g. venous system has more anastomoses (links)

Question 6

what is a thrombus made up of?

Answer 6

endothelial cells, platelets, coagulation cascade (fibrin)

Question 7

most common in middle age/elderly people with CV disorders =

Answer 7

arterial thrombus

increased incidence in smokers and diabetics

Question 8

venous thrombosis occurs in ___ ___ ______ and is the result of ______

Answer 8

any age person, immobility

Question 9

what makes up the virchows triad (thrombus formation)

Answer 9

1) alteration of blood constituents
2) damage to endothelial lining
3) altered blood flow

Question 10

formed from venous emboli that passes through the right side of the heart into the pulmonary artery

Answer 10

pulmonary embolism

Question 11

from arterial system to variety of organs

Answer 11

systemic embolism

Question 12

disease of the intima

Answer 12

atherosclerosis

Question 13

disease of the media

Answer 13

arteriosclerosis

Question 14

atherosclerosis causes:

Answer 14

endothelial damage → leads to narrowing/obstruction of vessels → lead to thrombosis

Question 15

arteriolosclerosis causes:

Answer 15

increased wall thickness, decreased elasticity, hypertension (high BP)

Question 16

how does an atheromatous plaque form?

Answer 16

asymptomatic fatty streak → atheromatous lesion → atheromatous plaque

Question 17

what are the 3 layers of an atheromatous plaque?

Answer 17

fibrous cap → cellular layer → necrotic core

Question 18

what things make up the fibrous cap of plaque?

Answer 18

→ smooth muscle
→ collagen
→ elastin
→ proteoglycans

Question 19

what things make up the cellular layer of plaque?

Answer 19

→ macrophages
→ T cells
→ smooth muscle

Question 20

what things make up the necrotic core of plaque?

Answer 20

→ macrophages taking up macrophage foam
→ cholesterol clefts
→ lipids
→ cellular debris

calcification of plaque often occurs

Question 21

what are the processes of plaque formation?

Answer 21

1) ENDOTHELIAL ACTIVATION AND DYSFUNCTION
(promotes lipid accumulation)

2) INFLAMMATORY RESPONSE
3) IMMUNE CELL RECRUITMENT
(macrophages ingest lipids → form foam cells)

4) RECRUITMENT AND PROLIFERATION OF SMOOTH MUSCLE & EXTRACELLULAR MATRIX SYNTHESIS

Question 22

what happens if a plaque has a thinner cap?

Answer 22

more likely to rupture

Question 23

what are the general consequences of plaque formation?

Answer 23

→ narrowing/obstruction of vessels
→ rupture
→ embolism
→ calcification

Question 24

what are the specific consequences of plaque formation?

Answer 24

→ myocardial and cerebral infarctions
→ aortic aneurysms
→peripheral vascular disease

Question 25

what is angina?

Answer 25

pain caused by narrowing of coronary artery

Question 26

coronary heart disease is caused by…

Answer 26

narrowing of coronary arteries

Question 27

complete blockage of coronary arteries leads to a ______ _______

Answer 27

myocardial infarction

Question 28

coronary heart disease causes _______ deaths per year in UK

Answer 28

70,000

Question 29

what are the risk factors of CHD?

Answer 29

age, sex, family history

smoking, diabetes, obesity, hypertension

lack of exercise, type A personality, alcohol consumption, soft water

Question 30

what are the causes of CHD?

Answer 30

→ blockage → restricted blood flow → e.g plaque
→ decrease of oxygenated blood flow (anaemia, co2 poisoning)
→ increased demand → hypertrophy → increase in left side heart size)

Question 31

how is a myocardial infarction caused?

Answer 31

blockage in coronary artery → deprives cells of blood + O2 → ischaemia, infarction, necrotic cell death

Question 32

arteriogenesis =

Answer 32

collateral vessel formation

Question 33

____ coronary artery is ______ so new vessel grows and attaches to _____ coronary artery

Answer 33

left, occulated, right

Question 34

what does PCI stand for?

Answer 34

Percutanous coronary interventions

Question 35

gives some examples of PCI

Answer 35

angioplasty → balloon opens blocked vessel

stenting → wire mesh → maintains lumen size

Question 36

reocclusion of vessels (endothelial + muscle cells may grow over stent and infringe lumen) =

Answer 36

restenosis

Question 37

how is restenosis preventable?

Answer 37

use of drug elution from stands that contain anti proliferative and healing agents

Question 38

what is stent thrombosis?

Answer 38

serious condition → serious clinical consequences

result of delayed or incomplete endothelialization

prolonged antiplatelet therapy is required

can result in platelet deposition and lumen narrowing

Question 39

blocks cell proliferation around the stent by slowly releasing a drug

Answer 39

drug eluding stent

Question 40

drug eluding stents prevent ______ that together with ____ could reblock the stented artery

Answer 40

fibrosis, clots

Question 41

reblocking the stented artery =

Answer 41

restenosis

Question 42

give examples of newer treatments for CHD

Answer 42

drug coated balloons, dissolvable stents

however long term effects are unknown