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Flashcards in Artherosclerosis Deck (18)
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1

Arteriosclerosis

Disease of small arteries and arterioles caused by HTN. Begins with endothelial injury

2

Monkeberg medial sclerosis

calcification of media in large arteries. seldom causes medical problems

3

atherosclerosis

fatty deposits in the arterial wall. caused by poor lifestyle choices. causes hardening

4

atheroma

basic lesion of atherosclerosis. fatty deposit in arterial wall. -obstruct blood flow and cause hypoxia (ischemia, infarct).
-weaken arteriole wall, causing dilation (aneurysm) > hemorrhage

5

atherosclerosis uncontrollable risk factors

age: dramatic rise 40-60, and increases thereafter
gender: men, post-menopausal women. in very elderly, more women than men
genetics: family hx
Vascular inflammation: in the absence of known inflammation, it's assumed to be vascular inflammation

6

CRP

made by liver. most valuable marker of systemic inflammation. independent risk factor in atherosclerosis. ?related or just a marker? tbd

7

controllable risk factors for atherosclerosis

High LDL: promotes athero. increased in consumption of saturated fats & trans fats (plant like unsaturated fats become animal like saturated fats) and cholesterol-rich foods. Lowered by statins
high HDL: associated w less risk of athero. increased by exercise and moderate alcohol consumption. marker, not cause, of athero avoidance
HTN: incr risk by 50%
Smoking: 1ppd doubles risk of CAD. cessation cuts risk by 50% after 1 yr
metabolic syndrome: insulin-resistance
diabetic hyperglycemia: ie diabetes. good sugar control mitigates athero
other: lack of exercise, obesity, stress

8

Athero pathology

Damaged endothelium becomes leaky, fat/cholesterol passes into arterial wall.
Endothelial cells become sticky
Neutrophils, macrophages and platelets stick to them.
Macrophages phagocytize the lipid to become foam cells
Collagen + extracellular matrix join, and the atheroma grows.
Atheroma causes turbulent blood flow, leading to more endothelial damage

9

Advanced athero

mix of fat,fibrous tissue, macrophages, few lymphocytes.

10

Most common places for atherosclerosis

1. lower abd aorta
2. coronary arteries
3. popliteal arteries
4. decending thoracic aorta
5. internal carotid arteries in neck
6. circle of willis at base of brain

11

Most dangerous atheromas

The new ones! They are soft, semi-solid, prone to sudden thrombosis and occlusion leading to infarct

12

Consequences of atherosclerosis (in order)

1. MI due to CAD
2.cerebral infarction
3. aortic aneurysm
4. PVD

13

Stenosis

Result of slow atheroma growth

14

brain and leg and heart ischemia lead to...

TIA + dementia
intermittent claudication
HF

15

old atherosclerosis

STABLE. They have a sealed fibrous cap. impede blood flow gradually, producing progressive downstream ischemia. If rupture of fibrous cap happens then thrombosis.

16

LDL and atherosclerosis

desirable LDL <100. Atherosclerosis does not develop in people with LDL 50-60.

17

HDL and atherosclerosis

above 60 is not associated with increased CV risk. values less than 40 are associated with high CV risk.

18

Statins

block liver enzymes important in cholesterol synthesis.