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Cardio Yr 2 > Ischaemic Heart Disease/ Atherosclerosis > Flashcards

Ischaemic Heart Disease/ Atherosclerosis Flashcards

1
Q

Modifiable risk factors of atherosclerosis

A 
smoking
lipid intake
BP
diabetes
obesity
sedentary lifestyle
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2
Q

Non-modifiable risk factors of atherosclerosis

A

age
sex
genetic background

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3
Q

By how much does smoking, hypertension and high cholesterol increase risk

A

16 times

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4
Q

Changes in epidemiology over the last decade for hyperlidaemia, hypertension, obesity

A

hyperlidaemia - reduced due to statins
hypertension - reduced to due antihypertensives
obesity - increased

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5
Q

Where does atherosclerosis often occur

A
  • bifurcation of carotid arteries
  • origins of subclavian and carotid arteries
  • where aorta branches into iliac arteries
  • particularly at the inside of bends/ at bifurcations
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6
Q

where is the fat mainly deposited in atherosclerosis

A

LDL deposit in the sub-intimal space + binds to matrix proteoglycans

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7
Q

Type II lesion

A

macrophage foam cells in sub-intimal space

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8
Q

Type III lesion

A

Foam cells accumulate until small pools of extracellular lipid

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9
Q

Type IV lesion

A

Core of extracellular lipid

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10
Q

Type V lesion

A

Fibrous thickening - lipid pool with scar tissue over it

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11
Q

Type VI lesion

A

Fissure and haematoma - when material in plaque hits blood, stimulates a clot

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12
Q

Role of monocyte macrophages in atherosclerosis

A

foam cell formation
cytokine + GF release (for scar formation)
Source of free radicals (damage DNA + RNA)
Metalloproteinases - cut up collagen

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13
Q

Role of vascular endothelial cells in atherosclerosis

A

barrier function - eg. to lipoproteins

leukocyte recruitment

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14
Q

Role of platelets in atherosclerosis

A

thrombus generation

cytokine + GF release

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15
Q

Role of vascular smooth muscle cells in atherosclerosis

A

Migration + proliferation
collagen synthesis
remodelling + fibrous cap formation

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16
Q

Role of T cells in atherosclerosis

A

Macrophage activation

17
Q

why are high risk of atherosclerosis patients injected with antibodies to IL-1

A

cholesterol crystal formation triggers inflammation - injected patients have lower risk of CVD event

18
Q

what is atherosclerosis

A

inflammatory disease of the arteries that cause most heart attacks/ strokes

19
Q

What is low density lipoprotein

A

‘bad’ cholesterol - synthesised in liver - carries cholesterol from. liver to body (need some - usually it is in excess so seen as bad)

20
Q

what is high density cholesterol

A

‘good’ cholesterol - carries form peripheral tissues back to liver - reverse cholesterol transport

21
Q

Oxidised/ modified LDL

A

free radicals + LDL = family of highly inflammatory + toxic form of LDL found in vessel walls

22
Q

Why are oxidised/ modified LDL bad

A

Oxidised/ modified LDL gets phagocytosed by macrophages = become foam cells + stimulates chronic inflammation

23
Q

What is familial hyperlipidaemia

A

autosomal dominant - massively elevated cholesterol due to a failure to clear LDL (liver has lost receptors to take it back in)

24
Q

what is a macrophage scavenger receptor

A

expressed on macrophages and they bind and internalise modified forms of LDL in blood vessel

25
Q

what are chemokines

A

small proteins chemoattractant to monocytes

26
Q

what does platelet derived growth factor do

A

vascular smooth muscle chemotaxis/ survival/ cell division

27
Q

what does transforming growth factor beta do

A

increased collagen synthesis

matrix deposition

28
Q

what does transforming growth factor beta do

A

increased collagen synthesis

matrix deposition

29
Q

How does macrophage apoptosis occur + contribute to atherosclerosis

A

Lipid overload - macrophage foam cells have protective systems to survive it but once overwhelmed they die + release macrophage tissue factors/ toxic lipids and once this meets blood = rapid thrombus

30
Q

What is Nuclear Factor kappa B

A

Transcription factor which regulates inflammation + switches on various inflammatory genes

31
Q

How is NFkB activated

A

Activated by inflammatory stimuli - scavenger receptors/ toll like receptors/ cytokine receptors like IL-1

Cardio Yr 2 (2 decks)

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