Vascular Disease

Question 1

What is arteriolosclerosis

Answer 1

Thickening and hardening of wall of arteriole

Question 2

What’s is arteriopath

Answer 2

Widespread disease of arteries

Question 3

What are the three steps in hypertensive arteriosclerosis

Answer 3

1) hypertrophy of media
2) fibroelastic thickening of intima
3) elastic lamina replication

Question 4

What are the stages in hypertensive arteriolosclerosis

Answer 4

Replacement of wall structures by amorphous hyaline material
Basement membrane how material = no smooth muscle
Perfusion failure and loss of function.

Question 5

What are the consequences of hypertension

Answer 5

Reduction in vessel lumen
Reduced blood flow
Ischaemia
Increased rigidity ( loss of elasticity and contractility)
Unresponsive to normal vessel control agents ( vasodilators)

Question 6

Where does atheroma not occur

Answer 6

Heart circ

Venous circ

Question 7

What’ is atheroma initially a disease of

Answer 7

Tunica intima

Question 8

What are the general four stages in development of an atheroma

Answer 8

Fatty stream
Lipid plaque
Fibrolipid plaque
Complicated atheroma

Question 9

Explain a fatty streak

Answer 9

Smooth endothelial surface is damaged
LDLs enter intima through damaged area
Lipids are phagocytosed by macrophages

Question 10

What is a the lipid plaque

Answer 10

Lipid released but macrophages
Macrophages secrete cytokines stimulating myofibroblasts to secret collagen
Early damage to elastic lamina and media

Question 11

What is a fibrosis is plaque

Answer 11

Collagen covers lipid plaque
Media thins with replacement of muscle with collagen
Vessels susceptible to stretch

Question 12

What is complicated atheroma

Answer 12

Lipids in intima become calcified and surfaces of fibrolipid plaque ulcerates exposing collagen with fibrin causes thrombosis
Activated coagulation cascade

Question 13

What are the complications of atheroma

Answer 13

Expansion of intima - reduction in size of lumen = decreased blood flow and ischaemia
Ulceration of atheromatous intima- predisposition to thrombus formation and vessel occlusion
Plaque fissure- formation and haemorrhage
Aneurysm- thinning and stretching due to decreased muscle and elastic fibres

Question 14

What does atheroma cause in coronary arteries

Answer 14

Angina

Question 15

What does atheroma cause in leg arteries

Answer 15

Intermittent claudication (limp)

Question 16

What does atheroma cause in mesenteric arteries

Answer 16

Ischaemic colitis (irritation and swelling)

Question 17

What does atheroma cause in cerebral and vertebral arteries

Answer 17

TIA

or stroke

Question 18

What is an aneurysm

Answer 18

Abnormal permanent focal dilation of an artery

Question 19

What is aneurysm due to

Answer 19

Atrophy of media, muscle and elastic fibres replaced by collagen, collagen not capable of recoil, with each systolic pulse wall of artery stretches and thins

Question 20

What types of aneurysms are there

Answer 20

Syphilitic- arch of aorta 
Developmental- cerebral vessels 
Dissecting- thoracic aorta 
Mycotic- endocarditis 
Bacterial septicaemia 
Infection of arterial wall

Question 21

What are lifestyle risk factors for atheroma

Answer 21

Smoking 
Physical inactivity
Obesity
Unhealthy high salt diet
Excess alcohol

Question 22

What treatable non- lifestyle risk factors are there for atheroma

Answer 22

Hypertension
High cholesteroleamia 
High lipideamia 
Diabetes
Kidney dysfunction

Question 23

What fixed risk factors are there for atheroma

Answer 23

Family history 
Make 
Male baldness
Early menopause
Age 
Ethnicity (India pakinstan Bangladesh and Sri Lanka)

Question 24

What is thrombosis

Answer 24

Normal mechanism to prevent bleeding when a vessel wall is breached

Question 25

What is atheroma

Answer 25

Arteriosclerosis of large and medium arteries characterised by hardening of arteries