Lecture 10 - Artherosclerosis

Question 1

Tunica media functions?

Answer 1

regulate flow by contraction, stabilise epithelium by secreting ECM and activating TGF-beta

Question 2

Elastic Lamina layers function?

Answer 2

assist continuous flow

Question 3

Most common positive risk factors?

Answer 3

hyperlipidemia (cholesterol), smoking, hypertension, diabetes mellitus, ageing

Question 4

Negative risk factors?

Answer 4

high levels of circulating high density lipoproteins, moderate alcohol, CV fitness

Question 5

Response to injury hypothesis - causes?

Answer 5

haemodynamic force, chemical insults, cytokines

Question 6

Response to injury theory - effects?

Answer 6

altered permeability, adhesion of leukocytes leading to inflammation, thrombosis

Question 7

Leukocyte migration into developing plaque?

Answer 7

circulating monocyte adherence, entry into lesion, differentiation into macrophage, ingested oxidised lipoproteins turning into foam cells, cytosolic contents enter ECM @ necrosis/apoptosis

Question 8

Role of smooth muscle cell activation and migration?

Answer 8

macrophages, platelets and EC produce growth factors activating SM, proliferate and migrate into tunica intima (accelerated by failed IEL).

Question 9

Role of lipoprotein entry and oxidation?

Answer 9

oxidised in plaques, attract monocytes, stimulate several cell types to release cytokines and GF, leading to dysfunction and apoptosis of EC, SM and macrophages

Question 10

Plaque instability?

Answer 10

thin fibrous cap, high lipid content of core, inflammation

Question 11

Occurrences leading to symptoms?

Answer 11

rupture, haemorrhage, thrombosis, tunica media weakness leading to dissection

Question 12

Common Clinical Consequences?

Answer 12

MI, peripheral vascular disease, CV disease

Question 13

Vulnerable plaque?

Answer 13

lack of fibrous cap, higher risk of rupture