w23 cardiovascular pathology

Question 1

LO

Answer 1

To understand the pathogenesis and clinical consequences of atherosclerosis

To learn about myocardial infarction and its management.

to fix w lec notes slide 13,14, 15 16 18 make cards & 23 onwards - lol

Question 2

rigidity (sclerosis)
and often thickening of blood vessel) is known as

Answer 2

Arteriosclerosis

Question 3

Whats the diff bw arteriosclerosis and arteriolosclerosis

Answer 3

arteriosclerosis - rigid & thicken. BV
arteriOLOsclerosis - small BVs ; fully thick ; hypertension & diabetes
- kidneys affected

Question 4

What is medial calcific sclerosis

Answer 4

Medium size arteries
Tunica media involved
No obstruction to blood
flow

Question 5

Define Atherosclerosis

Answer 5

Chronic inflamm. disorder of intima of L & Medium arteries
characterised by fibrofatty plaque called atheroma

Question 6

atherosclerosis is a disease of what sized arteries

Answer 6

large and medium

Question 7

3 Major causes of atherosclerosis are

Answer 7

Major cause of ischemic heart disease, Myocardial infarction, hypertension

modern lifestyle ?

Question 8

How long does primary atherosclerosis take to produce clinical manifestations?

Answer 8

Duration of dvpmt in decades (longest)

Question 9

How long does TRANSPLANT atherosclerosis take to produce clinical manifestations?

Answer 9

Narrowing of arteries at the points of engraftment of transplanted organs - Duration of dvpmt in mths –years

Question 10

How long does Re-stenosis after coronary bypass take to produce clinical manifestations?
(atherosclerosis)

Answer 10

duration of dvpmt in mths - yrs

Question 11

name the 2 hypothesis for possible causes of atherosclerosis

Answer 11

lipid hypothesis
injury hypothesis

Question 12

what is the lipid hypothesis for atherosclerosis

Answer 12

potential cause ; Lipid hypo:
- Diabetes
- Familial hyperlipidemia
- Hyperlipedemia due to life style
- Raised LDL in blood

Question 13

whats injury hypothesis for atherosclerosis

Answer 13

• Hypertension
  
  • Oxidised LDL
  • infections e.g .cytomegalovirus, herpes simplex viruses, enteroviruses, hepatitis A and chlamydia pneumoniae
    - Smoking

Question 14

what is familial hypercholesterolemia

Answer 14

Familial Hypercholesterolemia (FH)is a genetic disease which results in the reduced clearance of atherogenic LDL-cholesterol (“bad cholesterol”) in the blood, and an increased risk of early heart disease.
Ppl w FH - elevated LDL cholesterol levels from birth
children with FH show an increased thickness of arteries compared to their non-FH siblings by age of 11,
showing the process of atherosclerosis development starts early in life.

As a result of their FH, the incidence of fatal or non-fatal myocardial infarction without treatment is about 50% by the age of 50 years in men and about 30% by the age of 60 years in women.

Question 15

Name 4 uncontrollable risk factors of atherosclerosis

Answer 15

Sex (M > F)
Hereditary
Race
Age

Question 16

Name some controllable RFactors for atherosclerosis

Answer 16

High blood pressure
High blood cholesterol
Smoking
Physical activity
Obesity
Diabetes
Stress and anger
Diet

Question 17

Who discovered the lipid hypothesis for atherosclerosis

Answer 17

Rudolf Virchow 1856

Question 18

what does the lipid hypothesis for atherosclerosis propose

Answer 18

• proposes that infiltration of intima with lipid is the primary atherogenic event due to raised blood lipid levels

Question 19

• Increased cholesterol level is associated with a ________ ___________ of heart diseases

Answer 19

higher incidence of heart diseases

Question 20

define sources of triglycerides

Answer 20

saturated fat such as dairy products,
animal fat, vegetable oils

Question 21

name sources of cholesterol

Answer 21

Liver, kidneys, eggs and prawns are higher in dietary cholesterol than other foods.

Question 22

describe composition of a fatty acid (2 things)

Answer 22

Fatty acid is composed of a hydrocarbon chain with one terminal carboxyl group (COOH).

Question 23

whats the diff bw unsaturated Facids & saturated FAs

Answer 23

Unsaturated fatty acids have one or more carbon-carbon double bonds, whereas saturated fatty acid has no double bond in its hydrocarbon chain.

Question 24

whats oleic acid (example of smthn not needed)

Answer 24

Oleic acid is an example of a monounsaturated fatty acid. The most common polyunsaturated fatty acids are linoleic and arachidonic. Arachidonic acid (C20) is of particular interest as the precursor of a family of molecules, known as eicosanoids (from Greek eikosi, “twenty”), that includes prostaglandins, thromboxanes, and leukotrienes.

Question 25

in lipid metabolism how many pathways of 'frwd' lipid transport move from liver > peripheral tissues

Answer 25

two major pathways of “forward” lipid transport in which lipids move from the liver to the peripheral tissues.

Question 26

Exogenous path

Question 27

endogenous path

Question 28

in depth q of two lipid metabolism paths

Question 29

name the 3 lipid types in the blood

Answer 29

very low density lipoprotein (VLDL) low density lipoprotein high density lipoprotein

Question 30

Describe Very low density lipoprotein (VLDL) where made ? hwo it travels ? what it contains ? function?

Answer 30

Made in the liver - Secreted into the bloodstream - Contain triglycerides (TGs) mainly but also cholesterol Function: deliver TGs to body cells

Question 31

describe Low density lipoprotein (LDL)

Answer 31

Made in the Liver as VLDL - Arise from VLDL once it has lost a lot of its TG’s - Present in the bloodstream - Rich in cholesterol (contain 75% of cholesterol) Function: Deliver cholesterol to all body cells

Question 32

describe high density lipoprotein

Answer 32

- Made in the Liver and Small Intestine - Secreted into the bloodstream Function: pick up cholesterol from body cells and take it back to the liver = “reverse cholesterol transport” Potential to help reverse heart disease

Question 33

describe high density lipoprotein

Answer 33

- Made in the Liver and Small Intestine - Secreted into the bloodstream Function: pick up cholesterol from body cells and take it back to the liver = “reverse cholesterol transport” Potential to help reverse heart disease

Question 34

High risk for coronary diseases = high for VLDL high for LDL and is it high or low for HDL ?

Answer 34

low level risk for coronary diseases for HDL

Question 35

slide 13 to do

Question 36

name some lifestyle causes of hypercholesterolemia

Answer 36

Being overweight ● Heavy alcohol use ● Lack of exercise, inactive lifestyle & diet

Question 37

name some medical conditions that could contribute to causing hypercholesterolemia

Answer 37

Diabetes  ● Hypothyroidism ● Familial hypercholesterolemia (LDL receptor mutations and ApoB mutations have detected in bw 50- 80% cases of FH) ● Polycystic ovary syndrome

Question 38

description of physical characteristics of hypercholestrolemia

Answer 38

Xanthelasma palpebrarum, yellowish patches consisting of cholesterol deposits. These are more common in people with familial hypercholesterolemia

Question 39

what age does arteriosclerosis start

Answer 39

10-14 young

Question 40

name the 3 stages of arteriosclerosis

Answer 40

endothelial damage fatty streaks advanced lesions

Question 41

describe what happens in the endothelial damage stage of arterosclerosis

Answer 41

lipid enters into intima

Question 42

describe what looks like in the fatty streaks stage of arteriosclerosis

Answer 42

pale yellow, smooth surface, defined border that protrude into the lumen containing macrophages filled with lipid

Question 43

describe composition of the advncd lesions stage of arteriosclerosis

Answer 43

fibro fatty plaques (connective tissues, smooth muscle cells proliferation , accumulated lipids and lipid laden macrophages -foam cells, lymphocytes, lesion covered by fibrous cap)

Question 44

Name 3 clinical manifestations of atherosclerosis

Answer 44

CHeartDisease Cerebrovascular disease peripheral arterial disease

Question 45

Describe symptoms of coronary heart disease (rel. to atherosclerosis)

Answer 45

Stable angina, acute myocardial infarction, sudden death, unstable angina

Question 46

what clinical manifestation of atherosclerosis causes gangrene and intermittent claudication

Answer 46

peripheral arterial disease

Question 47

the 3rd clinical manifestation of atherosclerosis is cerebrovascular disease AKA ______

Answer 47

stroke

Question 48

what is gangrene

Answer 48

death of tissue in body foul smellin discharge of black foot ; surface & subsurface discolouration

Question 49

5 consequences of atheroma are..

Answer 49

Narrowing of lumen Plaques undergo changes: ulceration - fissuring haemorrhage into plaque - thrombus 3) Thrombus formation --> ischemia --> infarct 4) Embolism: thrombus can break away to become emboli 5) Atrophy of media --> weakening of wall --> aneurysm (abnormal dilatation of a vessel wall--> - rupture - thrombus

Question 50

complications of atherosclerosis

Answer 50

Thrombosis, thrombo-embolism Rupture – haemorrhage Aneurism – fusiform, dissecting, berry etc. Fibrosis and Calcification Ischemia: Angina/infarction Stroke, myocardial infarction, renal infarction Intermittent claudication, gangrene etc.

Question 51

2 diagnostic methods for atherosclerosis

Answer 51

Angiography Ultrasound

Question 52

what is angiography

Answer 52

guidewire w catheter inserted into femoral artery. It is moved into aorta and when it reaches opening of coronary arteries, contrast dye inj. to visualise the coronary arteries.