Coronary artery disease Flashcards

to beat mo the po

1
Q

What are the layers of an artery

A
Tunica adventitia 
Tunica media (vasvcular smooth muscle cells) 
Tunica intima (mono layer of specalised cells)
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2
Q

What do vascular endothelial cells release

A

baso reactive shit - they affect the blood vessel if it is in a relaxed or controlled state

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3
Q

What is important in regulating how endothelial cells release stuff

A

Shear stress

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4
Q

What does the endothelial cell layer provide

A

it stops platelets sticking to wall via having (Prostcytlin)

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5
Q

What is the contraction of smooth muscle cells controlled by in vessel walls

A

potassium

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6
Q

can smooth muscle cells proliferate and relocate

A

yes

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7
Q

What happens to a high level of LDL

A

it becomes oxidised and causes vascular damage

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8
Q

What is cholesterol an essential part of

A

cell membranes

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9
Q

Where can an atherosclerotic plaque likely form

A

where turbulent blood flow occurs eg bifurcations due to the wall thickness and this may then promote lipid retention and lesion formation

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10
Q

How does an atherosclerosis form

A
  • Injury to the endothelium
  • Endothelial dysfunction
  • Adhesion and migration of immune cells into the vessel wall
  • Foam cell formation leading to fatty streak
  • Progression to intermediate, fibrofatty lesion
  • Formation of fibrous plaque
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11
Q

what can cause damage to endothelial cells

A

smoking

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12
Q

How do fatty streaks form and at what age

A

Earliest lesion of atherosclerosis
• Appear at a very early age (<10 years)
• Consist of aggregations of lipid –laden macrophages and T lymphocytes within the intimal layer of the vessel wall

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13
Q

What is formed after a fatty streak

A

intermediate lesion

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14
Q

What happens in an intermediate lesion

A

Lipid laden macrophages (foam cells)
• Vascular smooth muscle cells
• Isolated pools of extracellular lipid

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15
Q

What happens after an intermediate lesion

A

Fibrous plaque

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16
Q

What is a fibrous plaque

A
  • Advanced lesion
  • Impedes blood flow
  • Prone to rupture
  • Covered by dense fibrous cap that overlies lipid core and necrotic debris
  • May be calcified
  • Contains:Smooth muscle cells, macrophages & T Lymphocytes
17
Q

What happens at the fibrous plaque when things go wrong

A

fibrous cap ruptures and then platelets can stick and then blood clot forms

18
Q

What does ptca stand for

A

PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

19
Q

What is restenosis

A

renarrowing of the arteries after angioplasty (now stents are insertsed to hold the vessel open)

20
Q

What do drug eluting stents do

A

they prevent restenosis and require antithrombotic agents to be taken