Vascular Disease

Question 1

What are the 3 stages of arteriosclerosis?

Answer 1

1. Hypertrophy of tunica media
2. Thickening of tunica intima - with fibroelastic tissue
3. Reduplication of elastic lamina

Question 2

Atheroma occurs in what type of systems?

Answer 2

High Pressured systems.

Question 3

Disease effects what layer of the blood vessel?

Answer 3

Tunica intima - later on effects tunica media.

Question 4

What are the 4 stages in development of an atheroma?

Answer 4

1. Fatty streak
2. Lipid plaque
3. Fibrolipid plaque
4. Complicated atheroma

Question 5

Name 3 complications with an atheroma.

Answer 5

• Reduced blood flow to and oxygenation of tissue.
• Ulceration of the atheromatous intima, predisposition to thrombus formation - vessel occlusion.
• Plaque fissure formation leading to haemorrhage.
• Los of elasticity - thinning and stretching due to replacement of muscle fibres.

Question 6

What is an embolism?

Answer 6

Transference of abnormal material by blood stream eventually impacts distal vessel.

Question 7

Thrombus in systemic vein eventually ends up as what?

Answer 7

Pulmonary Embolism.

Question 8

What are the steps in the formation of a thrombus?

Answer 8

1. Vessel wall breached.
2. Platelet aggregation.
3. Platelets release factors leading to the coagulation cascade.
4. Factors convert fibrinogen to fibrin.
5. Long fibrin molecules bind platelets and WBC together

Question 9

What factors predispose the formation of a thrombus?

Answer 9

• Damage to vessel wall (arteries)

- Stasis (veins and atrium)

Question 10

What factors predispose the formation of a thrombus?

Answer 10

• Damage to vessel wall (arteries)
• Stasis (veins and atrium)
• Change in the character of the blood.

Question 11

Thrombus becomes a pathological problem when not controlled by what?

Answer 11

Fibrinolysis.

Question 12

What are the steps in Fibrinolysis?

Answer 12

1. Plasma contains inactive proenzyme plasminogen.
2. Plasminogen is activated to plasmin by activators esp. t-PA - secreted by endothelial cells.
3. Plasmin fragments fibrin into degradation products (FDPs)
4. When fibrin formed, plasminogen and t-PA bind to it. t-PA converts all nearby plasminogen which degrades the fibrin.

Question 13

What is the definition of infarction?

Answer 13

Death of a tissue due to lack of oxygen following abrupt cessation of arterial supply or venous drainage.

Question 14

What are infarction’s caused by?

Answer 14

• Occlusion by atheroma alone.
• Occlusion by atheroma with plaque fissure.
• Occlusion by embolus.
• Occlusion by atheroma and thrombosis.

Question 15

What are infarction’s caused by?

Answer 15

• Occlusion by atheroma alone.
• Occlusion by atheroma with plaque fissure.
• Occlusion by embolus.
• Occlusion by atheroma and thrombosis.