Pathophysiology

Question 1

What makes up the first lesion possible in the artery before an atheromatous plaque?

Answer 1

Masses of lipid-laden macrophages

Question 2

What do early plaques show in the intima?

Answer 2

Smooth yellow patches

Question 3

What makes up the developed plaques?

Answer 3

Central lipid core with a fibrous tissue cap

Question 4

What gives the structural strength of the atheromatous plaque?

Answer 4

The collagens in the tissue cap

Question 5

What is the most important risk factor for atheromatous plaques?

Answer 5

Hypercholesterolaemia

Question 6

What are the signs on clinical examination of major hyperlipidaemia?

Answer 6

Corneal arcus

Xanthelasma

Question 7

When the atheromatous plaque ruptures what does it usually lead to?

Answer 7

Thrombosis

Question 8

What are the main preventative measures for atheroma?

Answer 8

Smoking cessation
BP control
Weight loss
Exercise

Question 9

What 3 things make up Virchow’s triad?

Answer 9

Changes in blood vessel wall
Changes in blood constituents
Changes in pattern of blood flow

Question 10

Give an example of a change in blood vessel wall

Answer 10

Endothelial injury

Question 11

What are the main risk factors for thrombosis?

Answer 11

Hypertension
High cholesterol diet
Smoking
Age
Gender
Obesity

Question 12

What is the definition of hypoxia?

Answer 12

Inadequate oxygen supply to meet needs of the tissue/organ

Question 13

What is the definition of ischaemia?

Answer 13

Inadequate blood supply to tissue/organ

Question 14

What is the definition of infarction?

Answer 14

Obstruction of blood supply to organ or region of tissue causing local death of tissue

Question 15

How can an atheroma lead to ischaemia?

Answer 15

An atheroma will reduce the coronary circulation and thus it will lead to ischaemia

Question 16

What are the main consequences of ischaemia?

Answer 16

MI
Cerebral infarction
Abdominal aortic aneurysm
Peripheral vascular disease
Cardiac failure

Question 17

What is a transmural infarction?

Answer 17

Ischaemic necrosis which affects the full thickness of the myocardium

Question 18

What is a subendocardial infarction?

Answer 18

Ischaemic necrosis mostly limited to a zone of myocardium under endocardial living of the heart

Question 19

When heart is unable to clear blood from the ventricles, what is the consequence on the cardiac output?

Answer 19

Cardiac output decreases

Question 20

If the Renal glomerular filtration rate decreases, what happens to the volume of fluid in the body?

Answer 20

It increases

Question 21

Which are the pressures under the heading “Starling’s forces”?

Answer 21

Hydrostatic Pressure

Oncotic pressure

Question 22

Which type of pressure pushes into the vasculature?

Answer 22

Oncotic pressure

Question 23

What can a disturbance in Starling’s forces lead to?

Answer 23

Oedema

Question 24

What happens to the hydrostatic pressure to cause a lymphatic obstruction?

Answer 24

The hydrostatic pressure is upset in some way

Question 25

Give 3 examples of congestion?

Answer 25

Deep Vein thrombosis
Hepatic cirrhosis
Congestive cardiac failure