Lecture 10- Atherosclerosis

Question 1

What is atherosclerosis?

Answer 1

Accumulation of lipid in the intima and media of arteries leading to their thickening and hardening.

Question 2

Macroscopic features of atherosclerosis?

Answer 2

Fatty streak

Simple plaque

Complicated plaque

Question 3

Common atherosclerosis sites?

Answer 3

Carotid arteries 
Coronary arteries 
Aorta 
Leg arteries 
Cerebral arteries

Question 4

Arterial anatomy?

Answer 4

Diagram

Question 5

Early atherosclerosis features?

Answer 5

Foam cells

Smooth muscle proliferation

Question 6

Later atherosclerosis features?

Answer 6

Fibrosis 
Necrosis 
Inflammatory cells 
Cholesterol clefts 
Plaque fissuring 
Damage to media

Question 7

Clinical effects of atherosclerosis?

Answer 7

Angina 
Sudden death
Myocardial infarction 
Arrhythmia 
Cardiac failure 
Cerebral ischaemia (mini stroke)

Question 8

What is mesenteric ischaemia?

Answer 8

Atherosclerosis leading to blockage of mesenteric arteries which supply the gut leading to intestinal infarction as well as malabsorption and ischaemic colitis

Question 9

Peripheral vascular effects of atherosclerosis?

Answer 9

Claudication, leriche syndrome, ischaemic rest pain and gangrene

Question 10

What is claudication?

Answer 10

Pain in legs upon exercise as not enough blood flow

Question 11

What is leriche syndrome?

Answer 11

Blockage of abdominal aorta as it transitions into common iliac arteries

Question 12

What is ischaemic rest pain?

Answer 12

Pain in legs or feet when lying down relieved by standing. More severe than claudication

Question 13

Atherosclerosis risk factors?

Answer 13

Age- older more likely
Gender (males more likely women protected before menopause)
Alcohol 
Smoking
High BP
High cholesterol
Obesity 
Diabetes 
Infection

Question 14

Family risk factor for atherosclerosis?

Answer 14

Hyperlipidaemia

Question 15

Physical signs of hyperlipidaemia that would cause concern for atherosclerosis?

Answer 15

Corneal arcus
Tendon xanthoma
Xanthelasma (yellow plaque on eyelids)

Question 16

Why can diabetes lead to atherosclerosis?

Answer 16

Associated with hyperlipidaemia due to fats being used instead of glucose.

Associated with hypertension

Question 17

Processes involved in atherosclerosis?

Answer 17

Damage to endothelial cells by LDLs, toxins and hypertension.accumulation of lipids which are consumed by macrophages producing foam cells. Smooth muscle proliferates and inflammatory cells are recruited by cytokines produced by foam cells. Foam cells form a hard plaque with a fibrous surface formed by the smooth muscle cells. Intima and media of artery can be affected. Can lead to aneurysm and rupture of plaque can lead to blocking of arteries

Question 18

Atherosclerosis prevention?

Answer 18

Stop smoking 
Reduce fat intake 
Lose weight 
Control diabetes 
Exercise 
Not too much alcohol 
Treat hypertension 
Lipid lowering drugs