L6 Atherosclerosis, thrombosis, embolism, ischaemia, infarction

Question 1

What is a white infarction

Answer 1

death of a tissue as a result of ischaemia, looks pale with red border, in tissues supplied by arteries

Question 2

What is a red infarction

Answer 2

congestion which leads to increased pressure and rupture of small vessels in an area of dual blood supply, venous occlusion

Question 3

What is an infarction

Answer 3

acute ischaemic necrosis, mostly caused by thrombosis or embolism

Question 4

Properties of endothelium (5)

Answer 4

barrier
normally anti-thrombotic (prostacyclin + nitric oxide inhibit platelet aggregation)
can be pro-thrombotic 
secrete vasodilators and constrictors
normally resistant to leukocyte adhesion

Question 5

What are platelets activated by

Answer 5

exposed collagen following vessel injury

Question 6

What is a thrombus

Answer 6

clotted mass which doesn’t move from site of origin

Question 7

What is thrombosis

Answer 7

formation of thrombus involving vessel walls, platelets and plasma proteins

Question 8

What does Virchows triad involve

Answer 8

Stasis, hypercoagulability, damage to endothelium

Question 9

What does stasis involve

Answer 9

plays important role in venous and arterial thrombosis
turbulence (aneurysm, atherosclerotic plaque)

slowing (post surgical, elderly, varicose veins, cardiac failure)

Question 10

What factors increase coagulation

Answer 10

post operative, increased oestrogen, sepsis, obesity, dehydration

Question 11

How can injury to the endothelium occur

Answer 11

smoking, direct trauma, infection, atherosclerosis, inflammation

Question 12

What are arterial thrombi mostly caused by

Answer 12

atherosclerosis (endothelial injury) or aneurysm (turbulence)

Question 13

What are venous thrombi mostly caused by

Answer 13

slowing of blood flow, deep leg and pelvic veins important

Question 14

Examples of thrombi fate

Answer 14

embolization, fibrinolysis, organization, persistence (eg. aortic aneurysms)

Question 15

What is an embolus

Answer 15

intravascular solid, liquid or gas carried in the blood stream to a remote site away from its origin

Question 16

What are the risk factors for deep vein thrombosis

Answer 16

THE TRIAD

Question 17

What is a pulmonary embolism

Answer 17

thrombi from deep VEINS of lower limbs embolise to the lungs

Question 18

What is the path of a pulmonary embolism

Answer 18

veins to inferior vena cava to RA to RV to pulmonary arteries in lungs then STOPS (IT CANNOT CAUSE A STROKE)

Question 19

What are the symptoms of a pulmonary embolism

Answer 19

most are asymptomatic, medium size = coughing up blood, large = sudden cardiac collapse

Question 20

What is the consequence of a large pulmonary embolism

Answer 20

death (right heart ventricle failure)

Question 21

What is atherosclerosis and what can it cause

Answer 21

formation of plaques on artery walls, chronic accumulation of lipids in intima of large and medium sized arteries
underlying cause of most heart attacks and stroke

Question 22

What do plaques consist of

Answer 22

cholesterol core, fibrous cap

Question 23

What are the risk factors of atherosclerosis

Answer 23

smoking, hypertension, increased age, being male, diabetes

Question 24

Five step pathogenesis of atherosclerosis

Answer 24

1. chronic endothelial injury
2. endothelial dysfunction
3. smooth muscle emigration and macrophage activation
4. macrophages and smooth muscle cells engulf lipid
5. smooth muscle cells proliferate

Question 25

What types of arteries are susceptible to atherosclerosis

Answer 25

elastic (aorta, carotid, iliac)

large and medium muscular (coronary, popliteal, cerebral)