Trigger - Atherosclerosis

Question 1

thromboresistant layer

Answer 1

endothelium (inner lining of tunica intima)

Question 1

Modulates tone, growth, hemostasis and inflammation throughout circulatory system

Answer 1

endothelium of the artery

Question 2

Consists of smooth muscle cells and an elastic membrane

Answer 2

tunica media

Question 3

Composed of fibroblasts, mast cells and nerve terminals

Answer 3

tunica externa/adventitia

Question 4

accumulation of what type of cells causes focal thickening of tunica intima and eventual developement of fatty streaks

Answer 4

foam cells!

fatty streaks can also contain t lymphocytes!!!

Question 5

this protein can trap VLDL and LDL

Answer 5

biglycan (created by coronary arteries)

Question 6

describe the process of fatty streak formation

Answer 6

1. Vascular injury precipitates monocyte binding to endothelium
2. Monocytes cross endothelium and become activated tissue macrophages
3. Macrophages “eat” oxidized LDL, becoming foam cells
4. T cells release cytokines, which further activates macrophages and cause smooth muscle cells to proliferate
5. Smooth muscle cells move to subendothelial space, producing collagen and taking up LDL, adding to foam cell accumulation

Question 7

A dense, collagen-based layer of connective tissue that covers the well-defined lipid core of an atherosclerotic plaque

Answer 7

fibrous cap

Question 8

accumulation of connective tissue, lipid containing smooth muscle cells and extracellular lpid pool

Answer 8

fibrous plaque

Question 9

Characterized by a necrotic lipid–rich core and calcified regions that develop over time

Answer 9

advanced lesions

Question 10

this type of remodeling is associated with unstable angina

Answer 10

positive remodeling

negative remodeling is associated with stable angina

Question 11

what does oxidized LDL do in the pathogenesis of atherosclerosis?

Answer 11

precipitates endothelial vasodilator dysfunction

Question 12

this is associated with hypercholesterolemia, HTN, DM , and smoking

Answer 12

endothelial dysfunction (the first step to developing atherosclerosis!)

Question 13

corrected with high doses of antioxidants, ACEI, and correction of HLD

Answer 13

endothelial vasodilator dysfunction

Question 14

why does endothelial vasodilator dysfunction occur

Answer 14

loss of endothelial-derived nitric oxide

Question 15

if a patient has unstable/ruptured plaques what type of inflammation is it likley assocaited with

Answer 15

active inflammation

Question 16

characterized by repeated ruptures and thrombosis followed by wound healing

Answer 16

silent plaque erosion/rupture

Question 17

what is considered premature CHD

Answer 17

Age <55 men
Age <65 women

Question 18

At what age do people become at risk for Atherosclerosis

Answer 18

Men >45
Women >55

Question 19

What is the MOA of cigarrette smoking promoting atherosclerosis

Answer 19

• increases platelet adhesiveness
• raises endothelial permeability
• stimulates SNS

Question 20

what populations will benefit with the use of a statin in regards to decreasing risk of CHD

Answer 20

• Individuals with clinical ASCVD (secondary prevention)
• Individuals with primary elevations of LDL–C ≥190 mg/dL
• Individuals 40-75 yrs with DM and LDL–C 70 to 189 mg/dL w/out clinical ASCVD
• Individuals w/out clinical ASCVD or DM who are 40-75 yrs with LDL–C 70-189 mg/dL and have an estimated 10-year ASCVD risk of >7.5%

Question 21

How does hypertension increase the risk of atheroclerosis/CHD

Answer 21

• mechanical injury to vessel wall
• thickens and stiffens heart muscle

Question 22

who is AAA screening reccomended in?

Answer 22

men 65-75 who have smoked

Question 23

who is HTN screening reccomended in

Answer 23

adults 18+ w/o known HTN

Question 24

who is DM screening reccomended in?

Answer 24

asymptomatic adults aged 35-70 years old who have overweight or obesity

Question 25

yayyyyy done

Answer 25