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year 5 histopath > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

atheroma

A

intimal lesion
atheromatous plaques > protrude into vessel lumen

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2
Q

risk factors

A

age - 40-60 years

sex- postmenopausal
oestrogen can be protective(?) but HRT doesn’t do this

hyperlipid
smoking
DM

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3
Q

modifiable risk factors

A

hyperlipidaemia
LDL-bad
HDL-good

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4
Q

statins effect

A

HMG-CoA reductase rate limiting enzyme in liver cholesterol synthesis

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5
Q

other risk factors for IHD

A

inflammation
metabolic syndrome
lipoprotein
haemostasis
lack of exercise
stress
obesity

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6
Q

pathogensis of atheroscleoris

respones to injury hypothesis

A

chronic inflammatory and healing response of arterial wall to endothelial injury

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7
Q

plaque formation - response to injury hypothesis

A

blood vessels more permeable
lipoprotein accumulation (LDL)
monocyte adhesion
migration into intima > foam cells

platelet adhesions

= plaque

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8
Q

factor release from activated platelet

A

smooth muscle

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9
Q

cholesterol cleft

A

Cholesterol clefts, that are depositions of cholesterol crystals in skin

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10
Q

fatty streak

A

earliest lesion
found at plaque sites in post mortem

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11
Q

consequences of atheroma

A

stenosis

critical stenosis > demand&raquo_space;>supply

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12
Q

stenosis

A

stable angina

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13
Q

plaques

A

erode
rupture
haemorrhage

thrombose = critical ischaemia

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14
Q

vulnerable plaques

A

large number of bone cells
fibrous cap is weak = increased risk of rupture

= physical stress

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15
Q

stable plaque

A

lipid core is small
fibrous cap is thick - so less likely to rupture

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16
Q

IHD presents

A

angina pectoris - stable or unstable

MI - = myocyte death and necrosis
chronic IHD w heart failure

sudden cardiac death

17
Q

stable angina

A

75% stenosis
pain on exercise for exaple

18
Q

angina pectoris

A

transiet ischaemia

19
Q

unstable angina

A

more frequent / longer onset w less exertion / at rest

disrupted plaque

superimposed thrombus

warning sign for impending infarction

20
Q

Myocardial response

A

blood supply affected
> loss of contractility

HF can precede myocyte death

irreversible after 30 mins

21
Q

MI 24 h morphology

A

pale edema > inflammation

22
Q

3/4 days MI morphology

A

haemorrhage
necrosis/ granulation

23
Q

thin, yellow 1/3 weeks

foamy

A

granulation tissue

24
Q

3/6 weeks later

A

tough white

dense fibrosis

25
Q

MI clinical features

A

10-15% asymptomatic or unusual

vomiting

CK, Troponin
subendocardial infarct

26
Q

MI complications

A

contractile dysfunction
arrythmia
myocardial rupture

27
Q

dressler syndrome

A

2/3 pericarditis

pericardial effusion, pleuritic chest pain, and elevated inflammatory markers

28
Q

complication

A
29
Q

sudden cardiac death

A

asystole
ventricular fibrillations

IHD is leading cause of death

30
Q
A

year 5 histopath (11 decks)

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