Nov22 M2-Pathology - Atherosclerosis Flashcards

1
Q

ats composition

A

soft granulous necrotic core + thick fibrous cap

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2
Q

ats step 1

A

endoth injury: lets lymphocytes, macrophages, monocytes through

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3
Q

ats step 2 (after macrophages in)

A

are activated, secrete ECM and induce other cells to do so. LDL gets in intima, oxidized and taken up by activated macrophages

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4
Q

ats step 3

A

macrophages activated form foam cells

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5
Q

ats step 4

A

SM cells, normally contractile, become synthetic: mitosis + make ECM + move from media to intima

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6
Q

ats step 5

A

SM cells activate macrophages, take lipids and form foam cells

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7
Q

foam cells origin

A

from macrophages and SM that take cholesterol (LDL)

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8
Q

why calcification in ats sometimes

A

SM (now synthetic) can become chondrocytes, deposit Ca, calcification

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9
Q

effect of ats on platelets

A

aggregate and adhere bc endoth dysfunctional now

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10
Q

fatty streaks cause

A

when both SM and macrophages take cholesterol

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11
Q

what causes stenosis

A

thickening of intima

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12
Q

fibrotic cap name + origin

A

atheroma. origin is ECM from SM

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13
Q

what’s found in center of atheroma

A

CH esters, lipid debris

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14
Q

fibrous cap components

A

SM cells, inflam cells, collagen, elastin, proteoglycans, new vessels

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15
Q

necrotic center composition

A

cell debris, cholesterol crystals, foam cells, calcium

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16
Q

vulnerable plaque def

A

big lipid core, thin fibrous cap. likely to rupture

17
Q

stable plaque def

A

thick fibrous cap, less lipid core: less likely to rupture

18
Q

inflam in vuln vs stable plaque

A

stable less inflammed

19
Q

why vuln plaque can rupture

A

lot of inflam, macrophages’ metalloproteinases, thin fibrous cap

20
Q

consequence of cap rupture

A

thrombus formation (core is very thrombogenic)

21
Q

complicated plaques

A

fissures, erosion, ulceration, calcification, thrombus, rupture

22
Q

pathophgy of aneurysm and rupture

A

thick cap and core, SM atrophy

23
Q

thrombotic stroke def

A

ulceration, rupture and thrombus or hemorrhage in plaque cause narrowing of lumen

24
Q

ats risk factor not usually covered

A

homocysteine mild elevation (can cause endoth damage and promote thrombosis)

25
Q

risk factor for ats of less importance

A

infection. conc. of antibodies assoc with severity

26
Q

why estrogen protective in ats

A

reduces LDL, increases HDL. antiplatelet action