funamentals of atehrsclerosis d

Question 1

what is atherosclerosis

Answer 1

the principle cause of heart attack, stroke and gangrene of the extremities

Question 2

main problem of atherosclerosis

Answer 2

plaque rupture leading to thrombus formation, partial/complete arterial blockage leading to a heart attack

Question 3

risk factors for atherosclerosis

Answer 3

• Age
• Tobacco Smoking
• High Serum Cholesterol
• Obesity
• Diabetes
• Hypertension
• Family History

Question 4

what is the best known risk factor for coronary artery disease

Answer 4

age

Question 5

distribution of atherosclerotic plaques

Answer 5

• Found within peripheral and coronary arteries
• Focal distribution along the artery length
• Distribution may be governed by haemodynamic factors:

Question 6

what are haemodynamic factors

Answer 6

Changes in flow/turbulence (eg at bifurcations) cause the artery to alter endothelial cell function. Wall thickness is also changed leading to neointima. Altered gene expression in the key cell types is key.

Question 7

structure of atherosclerotic plaque

Answer 7

lipid
necrotic core
connective tissue
fibrous cap

Question 8

what eventually happens to the plaque

Answer 8

eventually the plaque will either occlude the vessel lumen resulting in a restriction of blood flow (angina) or it may rupture (thrombus formation - death)

Question 9

what is the response to injury hypothesis of athescerlosis

Answer 9

• Initiated by an injury to the endothelial cells which leads to endothelial dysfunction.
• Signals sent to circulating leukocytes which then accumulate and migrate into the vessel wall.
• Inflammation ensues

Question 10

when is inflammation good

Answer 10

pathogens
parasites
tumours
wound healing

Question 11

when is inflammation bad

Answer 11

• Myocardial reperfusion injury • Atherosclerosis
• Ischaemic heart disease
• Rheumatoid arthritis
• Asthma
• Inflammatory bowel disease • Shock
• Excessive wound healing