L15 Atherosclerosis

Question 1

What is atherosclerosis? What is it caused by?

Answer 1

Atherosclerosis is thickening and hardening of arterial walls
Caused by foam cells

Question 2

What is arteriosclerosis?

Answer 2

Chronic disease of the arterial system, vessel walls are hardened and thickened

Question 3

What are some complications of atherosclerosis? (4)

Answer 3

• CVA
• MI
• Renal ischaemia
• DVT/Intermittent claudication

Question 4

What is the pathophysiology of atherosclerosis? (8)

Answer 4

• Damaged endothelial cells
• Triggers inflammatory response
• Growth factors secreted
• Monocytes adhere and become macrophages in the sub-endothelial space, releasing reactive oxygen species (ROS)
• Macrophages ingest lots of oxidised LDL, becoming a foam cell
• Foam cells aggregate or apoptosis occurs
• Unstable plaque ruptures
• Blood clot formed - thrombus, occluding blood flow

Question 5

What is an angiogram?

Answer 5

Imaging to see perfusion through the coronary vessels, to see location and extent of restriction of blood flow

Question 6

How to surgically treat a thrombus? (2)

Answer 6

Stent or bypass

Question 7

What are some risk factors involved in atherosclerosis? (environmental and biological) (10)

Answer 7

• HTN
• Smoking
• Diabetes
• Increased LDL
• Decreased HDL
• Oxidative stress
• Periodontal disease
• C-reactive proteins (CRPs)
• Fibrinogen
• Homocysteine

Question 8

What LDL is the worst for atherosclerosis and why?

Answer 8

• Smaller the worse (sdLDL) as it’s easier for them to penetrate the vasculature

Question 9

What is cholesterol efflux capacity?

Answer 9

Ability of HDL to remove cholesterol from lipid-laden macrophages in arterial walls

Question 10

What are some anti-atherogenic properties of HDL? (6)

Answer 10

• Cholesterol efflux and return cholesterol transport
• Antiinflammatory effects
• Antioxidant effects
• Antiapoptotic effects
• Antithrombotic effects
• Promotes nitric oxide

Question 11

How to measure someones cholesterol levels?

Answer 11

Lipoprotein analysis - blood test

Question 12

What is the total cholesterol amount (mmol/L) considered to be high?

Answer 12

Above or equal to 5.5mmol/L

Question 13

What is serum total cholesterol made of? (3)

Answer 13

LDL, HDL and TGs

Question 14

What is the difference between HDL and LDL, with HDL-C and LDL-C?

Answer 14

HDL and LDL are transporters, HDL-C and LDL-C is the amount of cholesterol within this lipoproteins

Question 15

What level of HDL-C is considered dyslipidaemia? In men and women

Answer 15

<1.0mmol/L in men
<1.3mmol/L in women

Question 16

What level of LDL-C is considered dyslipidaemia?

Answer 16

Above or equal to 3.5mmol/L

Question 17

What is the lipid triad? What does it include?

Answer 17

Lipid triad refers to the common atherogenic lipoprotein phenotype
It includes:
- Decreased HDL-C and APOAI
- Increased sdLDL and ApoB
- Increased plasma TGs