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Year 1: All Units > PP: Atherosclerosis > Flashcards

PP: Atherosclerosis Flashcards

1
Q

Define arteriosclerosis.

A

The thickening of the walls of the arteries and arterioles usually as a result of hypertension or diabetes.

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2
Q

Define atherosclerosis.

A

The accumulation of intracellular and extracellular lipid in the intima and media of large and medium sized arteries.

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3
Q

Define atheroma.

A

degeneration of the walls of the arteries caused by accumulated fatty deposits

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4
Q

Describe the macroscopic appearance of atherosclerosis.

A
  • Fatty streak
  • Simple plaque
  • Leads to complicated plaque
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5
Q

Describe the appearance of a fatty streak.

A

Lipid deposits in the intima results in a yellow slightly raised area.

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6
Q

Describe the appearance of a simple plaque.

A

Raised yellow/white area which is widely distributed with an irregular outline.

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7
Q

What might happen to a simple plaque which leads to complicated plaque formation?

A
  • Thrombosis
  • Haemorrhage into plaque
  • Calcification
  • Aneurysm formation
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8
Q

Describe the microscopic appearance of atherosclerosis.

A
  • Early changes: proliferation of smooth muscle cells, accumulation of foam cells, extracellular lipid disposition
  • Later changes: fibrosis, plaque fissuring, necrosis, cholesterol clefts, disruption of internal elastic lamina, damage extends into media, ingrowth of blood vessels
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9
Q

List the common sites for atherosclerosis.

A
  • Abdominal aorta
  • Coronary arteries
  • Carotid arteries
  • Cerebral arteries
  • Leg arteries
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10
Q

Describe the complications of ischaemic heart disease.

A
  • Sudden death
  • MI
  • Angina
  • Arrhythmias
  • Cardiac failure
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11
Q

Name some clinical effects of severe atherosclerosis.

A
  • Ischaemic heart disease
  • Cerebral ischaemia
  • Meseneteric ischaemia
  • Peripheral vascular disease
  • Abdominal aortic aneurysm
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12
Q

What are the clinical effects of cerebral ischaemia?

A
  • Transient ischaemia attack
  • Stroke
  • Multi-infarct dementia
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13
Q

What are the clinical effects of mesenteric ischaemia?

A
  • Ischaemic colitis
  • Malabsorption
  • Intestinal infarction
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14
Q

What are the clinical effects of peripheral vascular disease?

A
  • Intermittent claudication (intermittent pain when walking)
  • Leriche syndrome (pain in the bum, aka vibha)
  • Ischaemic rest pain
  • Gangrene
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15
Q

Name some risk factors of atherosclerosis.

A
  • Smoking
  • Hypertension
  • Impaired glucose tolerance
  • hyperlipidaemia
  • Alcohol
  • Apolipoprotein E genotype
  • Familial hyperlipidaemia
  • Geography
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16
Q

What advise would you give to a patient that wished to reduce their risk of atherosclerosis?

A
  • Stop smoking m8
  • Decrease your fat intake fatty
  • Lets treat your hypertension yeh?
  • Want some aspirin?
  • Think you need to cut back on the drinkys
  • Meet me at piyo, you need exercise
  • Treat diabetes
  • Lipid lowering drugs (if needed)
17
Q

Describe the cellular events which lead to the formation of a atherosclerotic lesion.

A
  1. Chronic endothelial injury
  2. Endothelial dysfunction with platelet adhesion
  3. Monocytes accumulate and release growth factors and cytokines
  4. Smooth muscle migrates from media to intima
  5. Macrophages and smooth muscle cells engulf lipid to form foam cells
  6. Smooth muscle proliferation, collagen and matrix deposition, extracellular lipid deposition, neurovascularisation
18
Q

Describe some of the mechanisms of atherogenesis.

A
  1. Atherosclerosis is due to injury
  2. Atherosclerosis is something to do with monoclonal devision as some are seen to have cells of the same origin (a bit like a tumour)
19
Q

Name the cells involved in atherosclerosis.

A
  • Endothelial
  • Platelets
  • Smooth muscle cells
  • Macrophages
  • Lymphocytes
  • Neutrophils
20
Q

What is the role of endothelial cells in atherosclerosis?

A
  • Alter permeability to lipoproteins
  • Collagen production
  • stimulation and proliferation and migration of smooth muscle cells
21
Q

What is the role of platelets in atherosclerosis?

A

Stimulation, proliferation and migration of smooth muscle cells

22
Q

What is the role of smooth muscle cells in atherosclerosis?

A
  • Take up LDL and other lipids to become foam cells

- Synthesise collagen and proteoglycans

23
Q

What is the role of macrophages in atherosclerosis?

A
  • Oxidise LDL
  • Take up lipids to become foam cells
  • Secretes proteases with modify the matrix
  • Stimulate proliferation and migration of smooth muscle cells
24
Q

What is the role of lymphocytes in atherosclerosis?

A

Stimulate proliferation and migration of smooth muscle cells

25
Q

What is the role of neutrophils in atherosclerosis?

A

Secrete proteases leading to continued local damage and inflammation

Year 1: All Units (66 decks)

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