Vascular Pathology: Arteriosclerosis

Question 1

What are 3 types of Arteriosclerosis

Answer 1

1. Atherosclerosis
2. Arteriolosclerosis
3. Monckeberg medial calcific sclerosis

Question 2

What is atherosclerosis

Answer 2

intimal plaque that obstructs blood flow

Question 3

What is composed of the intimal plaque of atherosclerosis?

What can this undergo?

Answer 3

• necrotic lipid core, mostly cholesterol
• fibromuscular cap
• can undergo dystrophic calcification

Question 4

Atherosclerosis involves what type of vessels and which are the most common

Answer 4

large- and medium- sized arteries

1. abdominal aorta
2. coronary artery
3. popliteal artery
4. internal carotid artery

Question 5

What are modifiable risk factors for atherosclerosis

Answer 5

hypertension
hypercholesterolemia, hyperlipidemia
smoking
diabetes

Question 6

What are non-modifiable risk factors for atherosclerosis

Answer 6

1. increase with age
2. gender - males and postmenopausal women, estrogen is protective
3. genetics- highly predictive

Question 7

What is the pathogenesis of atherosclerosis

Answer 7

1. damage endothelium
2. lipids leak into intima
3. lipds oxidized
4. consumed by macrophages via scavenger receptors making foam cells
5. inflammation/healing –> deposition of extracellular matrix and proliferation of smooth muscle

Question 8

The beginning morphological state of atherosclerosis is what and who is it commonly seen in?

Answer 8

fatty streaks- fat yellow lesions of intima consisting of lipid-laden macrophages

teenagers

Question 9

what do fatty streaks in atherosclerosis lead to

Answer 9

atherosclerotic sclerotic plaque

Question 10

Stenosis of medium-sized vessels results in

Answer 10

impaired blood flow

ischemia

Question 11

Stenosis of lower extremity arteries and popliteal artery leads to what

Answer 11

peripheral vascular disease

Question 12

Stenosis of coronary artery leads to what

Answer 12

angina

Question 13

Stenosis of mesenteric arteries leads to what

Answer 13

ischemic bowel disease

Question 14

what vessels does plaque rupture with thrombosis occur to have a myocardial infarction and stroke

Answer 14

MI: coronary
Stroke: middle cerebral artery

Question 15

Plaque rupture with embolization results in atherosclerotic emboli, characterize the embolus

Answer 15

cholesterol crystals

Question 16

Weakening of the vessel wall results in what?

Answer 16

aneurysm

Question 17

What are 4 complications of atherosclerosis

Answer 17

1. ischemia
2. thrombosis
3. embolization
4. aneurysm

Question 18

what is ateriolosclerosis

Answer 18

narrowing of small arterioles

Question 19

what are 2 types of arteriolosclerosis

Answer 19

1. hyaline

2. hyperplastic types

Question 20

What causes hyaline arteriolosclerosis

Answer 20

proteins leaking into the vessel wall

-produce vascular thickening

Question 21

what does hyaline arteriolosclerosis look like under microscopy

Answer 21

pink hyaline

Question 22

what are 2 diseases that can cause hyaline ateriosclerosis? what do these usually result in

Answer 22

1. benign hypertension
2. diabetes
   - reduces vessel caliber with end organ ischemia
   - glomerular scarring - arteriolonephrosclerosis –> chronic renal faliure

Question 23

What is hyperplastic arteriolosclerosis

Answer 23

thickening of vessel wall by hyperplasia of smooth muscle

Question 24

hyperplastic arteriolosclerosis is a consequence of what

Answer 24

malignant hypertension

Question 25

hyperplastic arteriolosclerosis results in what

Answer 25

reduced vessel caliber with end-organ ischemia

Question 26

hyperplastic ateriolosclerosis may lead to what? which can cause what

Answer 26

fibrinoid necrosis of vessel wall with hemorrhage

-causes acute renal failure with ‘flea-bitten’ apperance

Question 27

what is Monckeberg medial calcific sclerosis

Answer 27

calcification of media of muscular (medium-sized) arteries

-nonobstructive

Question 28

when is Monckeberg medial calcific sclerosis found

Answer 28

incidental finding in mammorgraphy and x-ray

- not clinically significant

Question 29

what does hyperplastic arteriolosclerosis look like under the microscope

Answer 29

onion ring