Pathology of an Atherosclerosis and Aneurysms

Question 1

An atherosclerotic plaque is early in formation and no extracellular matrix is present. What cells are present?

Answer 1

Macrophages - smooth muscle cells enter later in development and produce ECM

Question 2

What is nephrosclerosis?

Answer 2

Hyaline arteriolosclerosis of renal arteries

Question 3

What is the classification for an abdominal aorta dissection that is only proximal to the subclavian?

Answer 3

DeBakey 2 or Stanford Type A

Question 4

What is Monckeberg medial sclerosis?

Answer 4

Medical calcification of the radial and/or ulnar artery that presents without clinical significance.

Question 5

What is the classification for an abdominal aorta dissection that is only distal to the subclavian?

Answer 5

DeBakey Type 3 or Stanford Type B

Question 6

Smoking, hypertension, diabetes, and prior MI are all risk factors for atherosclerosis. What is the order of risk?

Answer 6

Prior MI > Diabetes > Smoking > Hypertension

Question 7

Women are less likely to develop atherosclerosis at a younger age than men. Why is this?

Answer 7

Estrogen is a protective factor. After menopause the risk of atherosclerosis between men and women levels.

Question 8

What part of the atherosclerotic plaque is relevant for MI risk.

Answer 8

Fibrous cap

Question 9

What is the most important risk factor for an upper aorta dissection?

Answer 9

Hypertension

Question 10

What is the most common cause of death due to an aortic dissection?

Answer 10

Pericardial tamponade

Question 11

What are the most common causes of hyaline arteriolosclerosis?

Answer 11

Hypertension & diabetes

Question 12

What is the clinical presentation of an aortic dissection?

Answer 12

Severe pain radiating to the back, new onset diastolic murmur, widened mediastinum on x-ray, unequal BP in arms, tamponade, syncope

Question 13

What is the most important risk factor for an abdominal aorta dissection?

Answer 13

Atherosclerosis

Question 14

What are the most important causes of aneurysms?

Answer 14

Atherosclerosis & hypertension

Question 15

What is the earliest and reversible stage of atherosclerosis?

Answer 15

Fatty streak

Question 16

What cells are responsible for depositing collagen and extracellular matrix in atherosclerotic plaues?

Answer 16

Smooth muscle cells

Question 17

A dissecting aneurysm of the aorta is a false aneurysm due to intimal teat. What is the mechanism?

Answer 17

Cystic medial degeneration (hypertension, Marfan’s, pregnancy)

Question 18

What is the cause of hyperplastic arteriolosclerosis?

Answer 18

Malignant hypertension

Question 19

What cells are present in a fatty streak?

Answer 19

Macrophages only

Question 20

What is the classification for an abdominal aorta dissection that is proximal and distal to the subclavian?

Answer 20

DeBakey 1 or Stanford Type A

Question 21

You are reading a pathology report of an artery from a patient with hypertension. The pathologist describes fibrinoid necrosis and an “onion skin” appearance. What is the diagnosis?

Answer 21

Hyperplastic Arteriolosclerosis

Question 22

This is thickening or narrowing of arterial lumina often due to hypertension.

Answer 22

Arteriolosclerosis

Question 23

What is the earliest pathologic change of atherosclerosis?

Answer 23

Intimal thickening

Question 24

True/False. Hyperlipidemia alone can initiate development of an atherosclerotic lesion.

Answer 24

True

Question 25

What is the most common location for an atherosclerotic plaque?

Answer 25

Abdominal aorta

Question 26

What is the first step in the formation of atherosclerosis?

Answer 26

Endothelial injury - this cannot be seen

Question 27

Chest pain with exertion that is relieved by rest is indicative of what kind of plaque?

Answer 27

Stable plaque - dense fibrous cap with minimal lipids and inflammation

Question 28

What is the difference between a true and false aneurysm?

Answer 28

With a true aneurysm, the vessel wall is intact. With a false aneurysm, there is a defect in the vessel wall causing blood to collect outside the vessel

Question 29

Macrophages and smooth muscle cells can generate foam cells. What else is needed for this generation?

Answer 29

Low-Density Lipoprotein (LDL)