atherosclerosis

Question 1

arteriosclerosis

Answer 1

thickening and loss of elasticity of arterial walls

Question 2

3 patterns of arteriosclerosis

Answer 2

1 - Monkeberg medial calcific sclerosis - deposits in muscular arteries in persons over 50 that do not encroach the vessel lumen
2 - arteriolosclerosis - small arteries and arterioles with narrowing of lumen and potential downstream ischemia
3 - atherosclerosis - large arteries, localized thickening of the wall with lumen narrowing

Question 3

3 consequences of atherosclerosis

Answer 3

1 - lesions mechanically obstruct blood flow
2 - lesions rupture, leading to emboli and thrombosis
3 - plaques weaken the underlying media and lead to aneurysms

Question 4

foam cells

Answer 4

monocytes that have taken up lipids from lipoprotein particles

Question 5

fatty streak

Answer 5

collection of foam cells in the intima

Question 6

atheroma features

Answer 6

• intimal thickening
• lipid accumulation
• raised focal lesions
• obstruction of lumen
• weaken tunica media underneath
• covered by endothelium or fibrous cap

Question 7

fibroatheroma

Answer 7

atheroma plus production of collagen creating a fibrofatty plaques

Question 8

complicated plaques

Answer 8

• the stage at which clinical manifestations appear

- calcification, ulceration, thrombosis, hemorrhage into plaque

Question 9

clinical complications of atherosclerosis are due to:

Answer 9

plaque rupture

Question 10

major targets of atherosclerosis

Answer 10

• large elastic arteries (aorta, carotid, iliac)

- large and medium sized muscular arteries (coronary and popliteal)

Question 11

symptomatic atherosclerotic disease most often involves there arteries supplying:

Answer 11

heart, brain, kidneys, lower extremities

Question 12

major consequences of atherosclerosis

Answer 12

• MI
• Cerebral infarction (stroke)
• aortic aneurysms
• peripheral vascular disease

Question 13

3 clinical phases involving advanced vulnerable plaque

Answer 13

1 - aneurysm and rupture - vessel wall opens to exterior environment
2 - occlusion by thrombus - after plaque rupture
3 - critical stenosis - plaque continues to grow until it occludes lumen

Question 14

epithelial injury hypothesis

Answer 14

• atherosclerosis is a chronic inflammatory response of the arterial wall initiated by injury to epithelium
• injury —-> dysfunction ——> atherosclerosis

Question 15

5 steps in pathogenesis of atherosclerosis

Answer 15

1 - chronic endothelial injury (hyperlipidemia, hypertension, smoking, toxins, viruses, immune reactions, etc.)
2 - endothelial cell dysfunction (increased permeability, leukocyte and monocyte adhesion and emigration)
3 - migration of smooth muscle cells into the intima
4 - monocytes/macrophages/SM cells engulf lipids and become foam cells
5 - smooth muscle proliferation and collagen deposition