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Pathology (m) > Atheroma > Flashcards

Flashcards in Atheroma Deck (39):
1

Define atheroma

A build up of fatty material on the inside of the wall of an artery

2

Define atherosclerosis

the progressive narrowing and hardening within an artery potentially resulting in a complete blockage

3

Where can atheromas occur?

Lower abdominal aorta
Coronary arteries
Popliteal arteries
Internal carotid arteries
Vessels of circle of willis

4

How may atheromas be initiated?

By chronic injury to endothelium resulting in chronic inflam

5

What may cause injury to endothelium?

Smoking
HTN
Disturbed flow
Hyperlipidaemia

6

How do atheromas progress?

As white cells, constituents of blood and fat

7

How are plaques formed?

A: Platelets activated
B: Platelets deposit chemokines on endothelial cells that compromise surface of arterial wall
C: Adhesion of monocytes to vessel wall
D: Monocytes then migrate into wall and turn into macrophages
E: LDL circulate and macrophages ingest them causing lipid rich foam cells
F: Foam cells mature into atherosclerotic plaques

8

What is a type 1 lesion?

Initial lesion

9

What is a type 2 lesion?

Fatty streak lesion

10

What is a type 3 lesion?

Intermediate lesion

11

What is a type 4 lesion?

Atheroma lesion

12

What is a type 5 lesion?

Fibroatheroma lesion

13

What is a type 6 lesion?

Complicated lesion

14

Clinical manifestation of an artery can cause...

Heart attacks
Angina
Ischaemic heart disease

15

Clinical manifestation of the aorta can cause...

Aneurysm

16

Clinical manifestation of the carotid artery can cause...

Strokes

17

Symptoms of peripheral vascular disease...

Pain in both legs when walking
Infected ulcers on legs and feet needing abx

18

Symptoms of stoke (cerebral infarction)...

Dysphasia
HTN with sudden onset
Left arm and leg weakness

19

What other presentations may signify atheroma?

Bowel ischaemia
Emboli
Renal artery stenosis

20

Treatment of atheromas?

Revascularisation (surgical)
Secondary prevention

21

IHD is not only low o2 but...

Low nutrients substrates and inadequate removal of metabolites

22

IHD means there is an imbalance between the...

Supply and demand of the heart for oxygenated blood

23

Causes of IHD...

Low/no flow of oxygenated blood (due to atheroma, embolism, spasm)
High demand for o2 (thyrotoxicosis/htn)

24

90% of IHD is caused by...

Coronary artery disease

25

Fixed risk factors of IHD...

Genetics
Age
Gender
+ Fam history

26

Potentially reversible risk factors with treatment...

Hyperlipidaemia
Smoking
HTN
Diabetes
Alcohol
Lack of exercise
Obesity

27

Signs and symptoms of IHD...

Chest pain (radiating to left and jaw)
SOB
Palps
Syncope
Nausea/sweating/pale
*NOTE: diabetic/elderly may not get chest pain*

28

Clincal presentations of IHD...

STEMI
NSTEMI
Unstable/stable angina
Sudden death

29

How can stable angina be relieved?

Rest and GTN spray

30

Stable angina may be caused by...

Plaque disruption/spasm

31

Unstable angina may be caused by...

Partial thrombosis/possible emboli

32

STEMI/NSTEMI may be caused by...

Plaque rupture/occlusion with thrombus

33

Name the complications of MI...

Cardiac arrest
Arrythmia
Pericarditis
Vulvular defects

34

Common treatment to all ACS and angina...

O2
Pain relief
Aspirin

35

Treatment for angina is...

Nitrates
B Blockers
Lifestyle changes

36

ACS treatment...

Thrombolytic therapy
PTCA (procedure to open arteries)
CABG (bypass, improves blood flow to heart)
Drugs

37

What does ACS include?

Unstable angina / MI

38

Major risk factors for developing atherosclerosis...

HTN
Diabetes
Hyperlipidaemia
Family history
Smoking
Low level of HDL

39

Other risk factors for developing atherosclerosis...

Obesity
Stress
Age
Sex
Physical inactivity
Homocystinuria