Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular System > Pathophysiology of Atheroma > Flashcards

Pathophysiology of Atheroma Flashcards

1
Q

What is atheroma/atherosclerosis?

A

The formation of plaque in the intima of large and medium sized arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is ischaemia?

A

A restriction of blood supply to tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Give a serious consequence of atheromatous plaques in the coronary arteries?

A

Angina due to myocardial ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Give an event which would complicate ischamia

A

Thromboembolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Give a condition which causes a decrease in vessel diameter but which may be age-related rather than atheromatous

A

Arteriosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give 4 arteries in which arteriosclerosis contributes to ischaemia in the elderly

A
  • cardiac
  • cerebral
  • colonic
  • renal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Give an event which would cause the clinical effects of arteriosclerosis to become more apparent

A
  • haemorrhage
  • major surgery
  • infection
  • shock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the earliest significant lesion present in patients at risk of developing atheroma?

A

Fatty streaks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In patients at risk, what might be formed from fatty streaks?

A

Atheromatous plaques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Give a brief description of the appearance of fatty streaks

A

Yellow linear elevations of intimal lining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

From what stage in life would early atheromatous plaques develop?

A

Young adult onwards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What cells cause early atheromatous plaques?

A

Lipid-laden macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Give a brief description of the composition of fully developed atheromatous plaques

A

Central lipid core rich in cellular lipids and macrophage debris, fibrous tissue cap, covered by arterial endothelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What protein - produced by smooth muscle cells in the fibrous tissue cap - provides structural strength in the atheromatous plaque?

A

Collagen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What kind of cells reside in the fibrous tissue cap?

A

Inflammatory cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why are the macrophages in atheromatous plaques “foamy”?

A

Due to uptake of oxidised lipoproteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What even occurs late in atheromatous plaque development?

A

Dystrophic calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Give an event that might occur in complicated atheroma

A
  • haemorrhage into plaque
  • plaque rupture/fissuring
  • thrombosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the most important risk factor in the development of atheroma and what does it cause?

A

Hypercholesterolaemia

Causes plaque formation and growth in absence of other known risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What results in biochemical evidence i.e. LDL, HDL, total cholesterol and lipid test results, would be indicative of hyperlipidaemia?

A

Results higher than the normal threshold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Give 3 signs/symptoms of major hyperlipidaemia

A
  • corneal arcus
  • tendon xanthomata
  • xanthelasmata
22
Q

Give 3 risk factors for developing atheroma other than hypercholesterolaemia and hyperlipidaemia

A
  • smoking
  • hypertension
  • diabetes mellitus
  • male
  • elderly

(obesity/sedentary lifestyle/low socio-economic status/low birthweight are less strong risk factors)

23
Q

How many steps are involved in the development of atheromatous plaques?

24
Q

What are the steps involved in the development of atheromatous plaques?

A
  1. Injury to endothelial lining of artery

2. Chronic inflammatory and healing response of vascular wall to injury-causing agent

25
What kind of exposure of the arterial wall would need to occur in order for atheromatous plaques to form?
Chronic/episodic exposure
26
What are the first 3 steps in the development of atheromatous plaques?
- endothelial injury and dysfunction - accumulation of lipoproteins in vessel wall - monocyte adhesion to endothelium
27
What occurs in the development of atheromatous plaques after monocytes adhere to the endothelium?
They migrate into the intimal and transform into foamy macrophages
28
What are the most important causes of endothelial injury?
- haemodynamic disturbances i.e. turbulent flow | - hypercholesterolaemia
29
How can chronic hypercholesterolaemia directly impart endothelial cell function?
By increasing local production of reactive oxygen species
30
What molecules aggregate in the intimal and are modified by the free radicals produced by inflammatory cells?
Lipoproteins
31
Give 3 functional alterations that occur in injured endothelial cells
- enhanced expression of cell adhesion molecules - high permeability for LDL - increased thrombogenicity
32
What is induced by the response to endothelial injury?
- chronic inflammatory process | - process of tissue repair
33
What is secreted by platelets, injured endothelium, macrophages and smooth muscle cells in atheromatous plaque development?
Growth factors
34
In established plaques, further plaque growth is also initiated by small areas of
endothelial loss
35
What is formed at denuded areas of plaque surface?
Microthrombi
36
Critical reduction of blood flow in distal arterial beds will occur with stenosis of what percentage of the vessel lumen?
> 50-75%
37
What would the clinical manifestation of a stenosed atheromatous coronary artery be?
Stable angina, ischaemic pain when exercising
38
What would be the main clinical sign of very severe stenosis?
Ischaemic pain at rest
39
What may be induced by ileal, femoral or popliteal artery stenosis?
Intermittent claudication
40
What would occur in an organ affected by longstanding tissue ischaemia?
Atrophy of the affected organ
41
What is caused by the total occlusion of an artery?
- irreversible ischaemia | - necrosis of tissues
42
Give 3 consequences of acute atherothrombotic occlusion
- myocardial infarct - stroke - lower limb gangrene
43
What event might follow the detachment of small thrombus fragments from thrombosed atheromatous arteries in a ruptured plaque?
Embolism distal to ruptured plaque
44
Give 3 complications following embolisation of the distal arterial bed in atheroma
- arrhythmias - cholesterol emboli - stroke
45
What slow, progressive and often asymptomatic event occurs as a consequence of atheroma?
Abdominal aortic aneurysm
46
What high-mortality event occurs in the sudden rupture of an abdominal aortic aneurysm?
Retroperitoneal haemorrhage
47
Give 3 distinct morphological features of atheromatous plaques that rupture with subsequent thrombosis
- thin fibrous cap - large lipid core - prominent inflammation
48
Give a feature of highly stenotic plaques
- large fibrocalcific component | - little inflammation
49
Give 3 methods of prevention of atheroma
- smoking cessation - control blood pressure - weight loss - regular exercise - dietary modifications
50
What drugs might be used in the secondary prevention of atheroma?
- cholesterol lowering drugs | - aspirin

Cardiovascular System (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions