Hyperlipid, arterio, athero 12/02 Flashcards
What are 3 signs of hyperlipidemia?
Xanthomas, tendinous xanthomas, corneal arcus.
How is called lipid deposits in cornea?
Corneal arcus.
What the most often occurs tendinous xanthomas?
In Achilles.
What the most often occurs xanthomas?
On eyelids. It is called xanthelasma.
What are xanthomas?
Plaques or nodules composed of lipid-laden histiocytes in skin.
In what ages the most often occurs corneal arcus?
In elderly (arcus senilis).
How is described (2) arteriosclerosis?
arterial wall thickening and loss of elasticity.
What arteries are affected by arterioslerosis?
small arteries and arterioles.
What are 2 types of arteriosclersis?
Hyaline and hyperplastic.
What causes (mechanism) hyaline arteriosclerosis? How is seen on microscopy?
Proteins leaking into vessel wall, producing vascular thickening. LM - proteins are seen as hyaline.
What diseases cause hyaline arteriosclerosis?
Long standing benign hypertension and diabetes.
Long standing benign hypertension and diabetes. What vessel disease? Type?
Hyaline arteriosclerosis.
Which vascular disease slowly progresses to chronic renal failure?
Hyaline arteriosclerosis.
What causes (mechanism) hyperplastic arteriosclerosis? How is seen on microscopy?
Thickening of vessel wall by hyperplasia of smooth muscle. LM - ‘‘onion skinning”.
What diseases cause hyperplastic arteriosclerosis?
Malignant hypertension, e.i. SEVERE hypertension.
Which vascular disease cause acute renal failure?
Hyperplastic arteriosclerosis.
What is the result (2) in organs of hyaline and hyperplastic arteriosclerosis?
Reduced vessel caliber with end-organ ischemia.
Reduced vessel caliber with end-organ ischemia. What causes those changes?
Hyaline and hyperplastic arteriosclerosis.
What type of renal failure cause hyperplastic arteriosclerosis?
Acute.
What produces glomerular scarring?
Hyaline arteriosclerosis.
What causes fibrinoid vessel wall necrosis and hemorrhage?
Hyperplastic arteriosclerosis.
What arterial disease can cause vessel wall necrosis?
Hyperplastic arteriosclerosis.
,,Flea-bitten” kidney appearance is common in ……………..
Hyperplastic arteriosclerosis, PSGN, RPGN, HS purpura, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, polyarteritis nodosa.
Which arterial disease affects medium size arteries?
Monckeberg sclerosis (medial calcific sclerosis).
Which arterial disease is not obstructive?
Monckeberg sclerosis (medial calcific sclerosis).
What parts are affected in Monckeberg sclerosis (medial calcific sclerosis)? What cause those changes?
Internal elastic lamina and tunica media. Vascular stiffing but no obstruction.
Which arterial disease cause stiffing of vascular wall?
Monckeberg sclerosis (medial calcific sclerosis).
In which arterial disease there is proliferation of smooth muscle cells in arteries?
Hyperplastic arteriosclerosis.
What arteries are affected by atherosclerosis?
Elastic arteries and large-medium size muscular arteries.
Which part of artery is affected by atherosclerosis?
Intima.
Which 2 arterial diseases cause obstruction?
arteriosclerosis and atherosclerosis.
What arteries are affected by atherosclerosis? > > >
Abdominal > coronary > popliteal > internal carotid.
Nonmodifiable factors of atherosclerosis?
Age (increase risk with age), gender (males and postmenopausal women), genetics (family history).
Modifiable factors of atherosclerosis?
Smoking, hypertension, diabetes, hypercholesterolemia.
Mechanism of atherosclerotic plaque formation.
Dysfunction of endothelial cell –> lipids leak into the intima –> lipids oxidized –> macrophages consume —> (kinda accumulation of macrophages and LDL) –> foam cells –> FATTY STREAKS –> because of inflammation and healing - –> smooth muscle proliferation and extracellular matrix depositions –> FIBROUS PLAQUE –> complex atheromas.
Smooth muscle cell ,,migration” in atherosclerotic plaque formation is related to ………… (2)
PDGF and FGF.
What are 2 merphologic stages of atherosclerotic plaque formation?
- Fatty streaks (yellow lesions of the intima of LIPID-LADEN MACROPHRAGES).
- Progresses to atherosclerotic plaque.
What receptors are used to consume lipids by macrophages?
Scavenger.
What 2 processes cause fibrous plaque formation from fatty streaks?
Smooth muscle cell migration/proliferation and extracellular matrix depostions.
What are complications of atherosclerosis because of impaired blood flow and ischemia? Their location.
Angina (in coronars), peripheral artery disease (lower extremities, e.g. popliteal), ischemic bowel syndrome (mesenteric arteries)
What are complications of atherosclerosis because of plaque rupture and thrombosis? Their location.
MI (coronars) and stroke (e.g. middle cerebral artery).
What are complications of atherosclerosis because of plaque rupture and embolization?
Atherosclerotic emboli, e.g. to lungs.
How is charecterised atherosclerotic emboli?
Cholesterol crystals within the embolus.
What are complications of atherosclerosis because of wall weakening?
Aneurysm.
What mechanisms cause atherosclerosis complications?
Ischemia or impaired blood flow; plaque rupture ant thrombosis; plaque rupture and atherosclerotic thrombus; weakening of vessels wall.
What is intimal plaque consisted of?
necrotic lipid core (cholesterol) and fibromuscular cap.
What process often intimal plaque undergoes?
Dystrophic caltification.
