CVS Pathology Flashcards
What is the difference between atherosclerosis and arteriosclerosis?
Atherosclerosis is the build up on plaque on arterial walls and arteriosclerosis (occurs with ageing and effects small blood vessels) is the stiffening of arteries.
What is the most important risk factor for atherosclerosis?
Hyperlipidaemia.
Name some non-modifiable factors for atherosclerosis.
Age- as you get older you are more likely to get this disease.
Gender- males have a higher risk of developing this disease and menopausal women due to not having enough oestrogen to keep the blood vessels open and patent.
Genes- Familial hypercholesterolaemia. (Mutation of LDL receptor gene). Autosomal dominant condition. LDL receptors take up “bad cholesterol” in blood- processed- some people have mutations of this gene (heterozygous (one mutant and one functioning-higher risk of atherscelorosis.)Both mutated- no LDL from circulation from liver- fatty streaks and deposits from early age eg. Children.
What happens in the basal state and activated state of an endothelial cells?
Basal state- Laminar flow, growth factors, growth factors, non-adhesive thrombogenic surface.
Activated state- turbulent flow, lipid products, viruses, hypoxia, acidosis, hypertension and an altered expression of cytokines/chemokines, increased expression of adhesion molecules and procoagulants.
What does neovascularisation mean?
Formation of new blood vessels.
What are the 5 stages of an atheroma?
- Chronic endothelial cell injury eg. hypertension, inherited.
- Permability increases and lipids are deposited in the intimal layers.
- Macrophages move in and digest these lipids. This creates foam cells/fatty streaks.
- Smooth muscle proliferation- Macrophages produce IL-1 which activates T cells. More cytokine/chemokines/inflammatory cells eg. FGF.
- Fibrous tissue formation over the lipid is formed an an atheroma is formed.
Dystrophic calcification may occur at later stages.
Meaning of dystrophy?
When the organ/tissue wastes away.
What are the effects of artherosclerosis?
Decreased blood supply to tissue/organ (ischemia)- sometimes.
Complete obstruction (infarction (cell death is result)).
Complete occlusion of the blood vessel leads to infarction.
Thrombosis (blood clot of top of atheroma)- complete blockage.
They break off and create…
Embolism (bit of thrombus broken off).
What clinical conditions could these lead to?
Depend on size of blood vessel and what organ is being supplied. Stenosis of bv leading to a decrease in blood supply (ischemia).
What are some effects of peripheral vascular disease?
ischmemia
claudication
gangrene
coagulation and necrosis/infection
What is an aneurism and what one is the most common?
Abnormal dilation of a blood vessel or in the cardiac wall. They are caused by a number of developmental, degenerative and traumatic factors.
Abdominal aortic aneurism is the most common.
What type of necrosis is an MI?
Coagulation necrosis.
How can you identify coagulation necrosis histologically?
Cells retain outline so can be identified
Cytoplasm becomes darker
Remains of nuclei
Striations lost
Inflammatory cells-which type comes first?
Which type comes later?
Granulation tissue- components.
