Lec 2 🪄 Flashcards
What’s the meaning of arteriosclerosis ⁉️
🔹artial wall thickning and losing of elasticity
Arteriosclerosis is characterized by finding a lesion called ⁉️
🔺intimal lesion ➡️atheromas
➡️atheromatous
➡️atherosclerotic plaques
What’s the components of the atheromas (intimal lesion) ⁉️
🔹soft friable lipid corse ➡️cholesterol and cholesterol esters ,necrotic debris
🔹this friable lipid course is covered by ➡️fibrous cap 🧢
What’s the complication if the atherosclerosis plaque enlarged ⁉️
🔸blood vessels obstruction
🔸stenosis
What’s the complication if atherosclerosis plaque got raptured ⁉️
🔸sudden vessels oclussion
🔸thrombosis formation
What’s the complication if the atherosclerosis plaque got thickned⁉️
🥲the perfusion will decrease to underlying media
🪄changes in ECM and blood vessels weakness
What’re the components of fibrous cap ⁉️
🔺collagen 🔺SM 🔺elastin 🔺foam cell 🔺macrophages 🔺lymphocytes 🔺proteoglycan
Mention the nonmodifiable risk factors for atherosclerosis ⁉️
🔹age
🔹gender
🔹family history
🔹genetic abnormalities
Family history nonmodifiable risk factors ⁉️
🔹Hypercholestrolemia
🔹DM
🔹hypertension
Major risk factors for atherosclerosis development is ⁉️
✔️🙂hyperlipidemia
✔️🙂hyper cholesterolemia
What’s the difference between LDL and HDL ⁉️
LDL➡️ bad cholesterol (so we need it in a little level )➡️distributes cholesterol to peripheral tissues
HDL ➡️good cholesterol (so we need it in a higher level)➡️mobillize cholestrol from plaques to liver for biliary excretion
What’s the drug of choice in hyperlipidemia atherosclerosis treatment ⁉️
🔷Statins ➡️inhibit cholesterol synthesis
Additional risk factors for atherosclerosis plaque rapture ⁉️
🔹inflammatory cell present during all stages of atheromatous plaque formation
What’s the systematic marker of inflammation ⁉️
🔶C-reactive protein ➡️CRP
🔶it’s the simplest and most sensitive
What’s the crp ⁉️
🔆It’s synthesized by the liver in response to inflammatory cytokines
When the CRP is reduced ⁉️
❄️stop smoking
❄️weight loss
❄️exercise
What’s the effect of hyper homocysteinemia on atherosclerosis ⁉️
Homocysteinemia ➡️inborn error of metabolism ➡️elevated circulating homocysteine ➡️early onest for vascular disease,storke,thrombosis,coronary atherosclerosis
What’s could increase the level of homocysteine ⁉️
🔅law folate intake
🔅law B12 intake
What’s the effect of lipoproteina on atherosclerosis ⁉️
🔻it’s an LDL like particle
🔻they increase the risk of coronary and cerebrovascular disease
🔻it don’t depend on LDL level
🔻increase procoagulant levels
What’s the effect of colonal hematopoiesis⁉️
Major clone of cell in bone 🦴 marrow ➡️mutation in one or more wallcharacteized oncogenes or tumor suppressor gene
Does the colonal hematopoiesis effect the normality of blood 🩸⁉️
No
Pathogenesis of atherosclerosis ⁉️
🔺EC injury ➡️endothelial dysfunction ➡️increased permeability and thrombosis
🔺acummulation of lipoprotein ➡️lDL and cholesterol
🔺platelets adhesion
🔺monocytes adhesion to endotheliam ➡️migrate to intima ➡️differentiate into macrophages and foam cell
🔺lipid accumulation in macrophages
🔺SMC recruitment due to factors released from microphage
🔺SMC proliferation and ECM production
Plaque tend to occur in which area⁉️
🔺ostia of vessel
🔺branch point
🔺posterior wall of abdominal aorta 🫀
How the lipids are transported in blood 🩸⁉️
🐦bounded to specific apoproties ➡️forming lipoprotein complex
Dyslipoproteinemias ⁉️⁉️⁉️
Mutations in genes that encode apoprotines ➡️lipoprotein receptors
هاي امراض رح تزيد اللlipid في الدم
Inflammation effect on atherosclerosis ⁉️
It effect 🔹initiation 🔹progression 🔹complication Of atherosclerosis
🔷What’s the effect of monocytes in atherosclerosis ⁉️
🔆it differentiates into macrophages to ingulf lipoprotein and oxidized LDL
🔶what’s the effect of T lymphocytes on atherosclerosis ⁉️
🔸increase intima interact with macrophages
Morphology of atherosclerosis ⁉️
🔷fatty streak ➡️developed into atherosclerosis plaque
What’s the fatty streaks ⁉️
🔺elongated lesion 1cm ➡️minute yellow lesion on flat muscle
Fatty streaks can apper in which age ?
🔹in the aorta of infants 👶🏻 from 1 year
🔹not all of fatty streaks will develop into ➡️atherosclerosis plaque ⛔️💢
Components of faty streak ⁉️
💢lipid -filled foamy macrophages
💢don’t cause flow disterbuse ⛔️
Atherosclerosis plaque ⁉️
💢white to yellow lesion ➡️0.3 to 1.5
💢ulceated plaque ➡️red brown color
💢found in local flow disturbance such as branch point
🙂In descending order of severity mention places where the atherosclerosis plaque are found ⁉️
🔆abdominal aorta ➡️coronary artery ➡️popliteal ➡️internal cartoid
🔆even in the same patient it’s more sever in aorta than cartoid
Mention places that it’s rare to find atherosclerosis plaque in it ⁉️
💢upper extremities
💢mesentric arteries
💢renal arteries
⛔️not on the ostia
