vascular disease pathology 2

Question 1

how does a thrombus form

Answer 1

damage to blood vessel
endothelial cells lifted up
platelets are attracted to collagen found underneath endothelial cells
platelets then gather
positive feedback loop leading to platelet aggregation
also blood clotting occurs- fibrinogen to fibrin

Question 2

factors which can precipitate thrombosis in blood vessesl

Answer 2

change in vessel wall
change in blood flow (change in laminar flow)
change in blood constituents (e.g. platelet numbers)

Question 3

causes of ischaemic disease

Answer 3

atheroslerosis
myocaridal hypertrophy
small vessel disease

Question 4

athersclerosis

Answer 4

disease of arterial blood vessesl

Question 5

myocardial hypertrophy

Answer 5

increase in heart muscle due to increase in cell size

Question 6

athersclerosis

Answer 6

plaque has reduced the lumen size

Question 7

risk factors for athlesclerosis

Answer 7

• industrial deprived areas
• cigarette smoking (nicotine damages endothelial cells, can lead to atherosclerotic plaque formation)
• Hypertension (HBP, due to endothelial cells being damaged)
• uncontrolled diabetes mellitus
• hyperlipidaemia

Question 8

what can left ventricular hypertrophy lead to

Answer 8

ischemic heart pathology

blood low is the same but more muscle needs blood supply

Question 9

what can cause hypertrophy of the heart

Answer 9

calcified valves
heart has to work harder to move blood through, hypertrophy will occur
more hypertrophic more blood requried

Question 10

what keeps vessels open

Answer 10

nitric oxide

Question 11

types of ischaemic heart disease

Answer 11

regional transmural myocardial infarction
subendocardial infarction
chronic ischaemia

Question 12

regional transmural myocardial infarction

Answer 12

death of heart muscle due to lack of blood
blockage in one of the main coronary artery
lack of collateral circulation from other vessels

Question 13

subendocardial infarction

Answer 13

inner part of ventricle dies
sever coronar artery atherosclerosis in all 3 coronary arteries
sudden reduction in blood flow

Question 14

chronic ischaemia

Answer 14

fixed atqheroscleroci lesions
angina, myocardial fibrosis, hibernating myocardium

some heart muscle die over time, but there is still some heart muscle alive

Question 15

complications of myocardial infarction

Answer 15

• sudden death
• arrhythmias (particularly atrial fibrillation)
• cardiac failure
• mitral incompetence
• pericarditis
• cardiac rupture
• mural thrombosis
• ventricular aneurysm
• pulmonary emboli

Question 16

cardiac rupture

Answer 16

weakening of the wall due to muscle necrosis and acute inflammation
rupture into pericardial sac
rupture into interventriclar septum

Question 17

mural thrombosis

Answer 17

thrombosis on the abnormal endothelial surface following infarction
embolisation to any arterial site, causes further infarcts in the rest of the body

Question 18

what is hypertenion

Answer 18

high BP
over 140 systolic

• can have later in life due to aorta being less elastic

Question 19

primary vs secondary hypertension

Answer 19

primary - no cause

secondary - identifiable cause

Question 20

secondary causes of hypertension

secondary means identifiable cause

Answer 20

renal
- salt and water overload
endocrine
- cushings, adrenal gland

coarctation of aorta
- stenosis in aorta
blood pressure higher in upper body

Question 21

clinicopathological classification of hypertension

Answer 21

benigin
- long asymptomatic period
increased frequency of complications later

Malignant
- raised diastolic
symptomatic

Question 22

effects of hypertension

Answer 22

• accelerated atherosclerosis
• sclerosis of smaller vessels (particularly in the kidney so can lead to kidney failure)
• microaneurysms and haemorrhages
• kidney/heart failure
• cerebral haemorrhages = strokes