The Pathophysiology Of Atherosclerosis

Question 1

Atherosclerosis does not occur at random. Lesions occur at specific vessel sites such as

Answer 1

Bifurcations, Branch Points, and Regions of high curvature

Question 2

Mechanical arterial endothelial injury causes

Answer 2

Atherogenic arterial blood flow patterns

Question 3

Characterized by low flow, gradients, and flow reversal

Answer 3

Atherogenic

Question 4

Cigarette smoking and diabetes both cause

Answer 4

Dyslipidemia

Question 5

Dyslipidemia from cigarette smoking is caused by

Answer 5

Nicotine and oxidizing chemicals

Question 6

The glycation of EC proteins and lipoproteins seen in diabetes causes

Answer 6

Diabetes

Question 7

Evidence of lipoprotein deposition appears as early as age

Answer 7

20

Question 8

Endothelial dysfunction allows entry and modification of lipids in the

Answer 8

Subendothelial space

Question 9

Function in the absorption of dietary lipids

Answer 9

Lipoproteins

Question 10

Transport triglycerides, cholesterol, and fat-soluble vitamins from the liver to peripheral tissues

Answer 10

Lipoproteins

Question 11

Chylomicrons are formed with the truncated protein

Answer 11

ApoB-48

Question 12

In the blood, what three proteins do chylomicrons acquire from HDL?

Answer 12

ApoA, ApoE, and ApoC

Question 13

Primarily a triglyceride particle that transports dietary triglyceride to adipose tissue and muscle

Answer 13

Chylomicrons

Question 14

What is the lipoprotein content of chylomicrons?

Answer 14

ApoC-II and ApoE (from HDL) and ApoB-48

Question 15

Activated by ApoC-II on the CM surface

-Removes 80-90% of TAG in the muscle and adipose tissue

Answer 15

Lipoprotein Lipase

Question 16

Chylomicrons remnants have ApoE-mediated uptake by

Answer 16

Hepatocytes

Question 17

In the hepatic pathway, triglycerides (60%) and cholesterol (25%) are released as

Answer 17

VLDL

Question 18

VLDL are released with which protein?

Answer 18

ApoB-100

Question 19

ApoE and C as well as cholesterol esters are acquired from

Answer 19

HDL

Question 20

Interacts with LPL to hydrolysis TGs to FFA in the periphery

Answer 20

VLDL

Question 21

50% of VLDL remnants (aka IDLs) are cleared by hepatic receptors that recognize

Answer 21

ApoE

Question 22

The remaining VLDL remnants are processed by hepatic triglyceride lipase and LPL to form

Answer 22

LDL

Question 23

Most cholesterol in the blood is associated with

Answer 23

LDL

Question 24

The normal role of LDL is to deliver cholesterol to the tissues for

Answer 24

Biosynthesis

Question 25

What percentage of LDL are picked up by hepatocytes -Remainder is by peripheral tissue

Answer 25

80%

Question 26

LDL contain one apoprotein

Answer 26

ApoB-100

Question 27

Has a high proposition of free cholesterol and cholesterol esters

Answer 27

LDL

Question 28

LDL is recognized by the LDL receptor. This recognition process requires

Answer 28

ApoB-100

Question 29

Involved in reverse cholesterol transport

Answer 29

HDL

Question 30

Inherited disorders associated with severe elevations in total and LDL cholesterol result in

Answer 30

Accelerated Atherosclerosis

Question 31

Autosomal dominant disorder characterized by severe elevations in total cholesterol and LDL-C

Answer 31

Familial Hypercholesterolemia

Question 32

Homozygous familial hypercholesterolemia results in

Answer 32

Severely elevated cholesterol levels

Question 33

Total cholesterol in homozygous Familial Hypercholesterolemia (FH) and LDLc levels are

Answer 33

Greater than 600 mg/dL

Question 34

What are the LDLc levels in heterozygous FH?

Answer 34

Greater than 250 mg/dL

Question 35

93% of cases of FH are due to mutations in the

Answer 35

LDL receptor

Question 36

5% of FH cases are due to mutations in -Inhibits binding of LDL to LDL-R

Answer 36

ApoB-100

Question 37

2% of FH cases are due to a gain of function mutation in -Enhances LDL-R degredation

Answer 37

PCSK9

Question 38

Characterized by very high serum triglycerides -Cholesterol is usually normal

Answer 38

Hyperlipoproteinemia (Type 1a)

Question 39

Type 1a hyperlipoproteinemia is due to a deficiency in

Answer 39

Lipoprotein lipase OR ApoC-II

Question 40

A clinical manifestation of type 1a hyperlipoproteinemia is

Answer 40

Eruptive Xanthomas

Question 41

Proliferation and ECM synthesis helps to stabilize plaques with a

Answer 41

Fibrous Cover

Question 42

Persistent inflammation leads to plaque disruption and

Answer 42

Vessel Thrombosis

Question 43

Contribute to plaque progression and instability

Answer 43

Matrix Metalloproteinases

Question 44

What are 4 modifiable risk factors of atherosclerosis?

Answer 44

Dyslipidemia, hypertension, cigarette smoking, and diabetes mellitus

Question 45

Deals with delaying or preventing the onset of atherosclerosis -Patients have no evidence of vascular disease

Answer 45

Primary prevention of atherosclerosis

Question 46

May be. Marker for inflammation associated with atherogenesis

Answer 46

C reactive protein

Question 47

Ancient, highly conserved protein that is an acute phase reactant

Answer 47

C-reactive protein

Question 48

Released from the liver in response to inflammatory signals (i.e. IL-6)

Answer 48

C-reactive protein

Question 49

A marker of inflammation associated with CAD

Answer 49

C-reactive protein

Question 50

Similar to LDL and structurally related to plasminogen

Answer 50

Lipoprotein (a)

Question 51

Is a 1.5-2x risk factor for CAD

Answer 51

Lipoprotein (a)

Question 52

Independent risk factor for cardiovascular disease

Answer 52

Homocysteine