Atheroma Flashcards

1
Q

What is atheroma?

A

The formation of plaques in the intima of artery walls

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2
Q

What does atheroma in coronary arteries lead to?

A

Ischemia

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3
Q

What is arteriosclerosis?

A

The thickening and hardening of artery walls reducing the the vessel’s diameter

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4
Q

What is arteriosclerosis caused by?

A

Old age

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5
Q

What does arteriosclerosis lead to?

A

Ischemia (various types)

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6
Q

What are the 3 stages of development of an atheroma?

A

Fatty streak -> Early atheromatous plaque -> Fully developed atheromatous plaque

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7
Q

What is the clinical significance of a fatty streak?

A

No clinical significance (just a small mass of lipid-laden macrophages)

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8
Q

What age group are fatty streaks found in?

A

Children

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9
Q

What age group are early atheromatous plaques found in?

A

Young adults onwards

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10
Q

What is the structure of a fully developed atheromatous plaque?

A

A central lipid core with a fibrous tissue cap covered by arterial endothelium

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11
Q

What provides the cap of atheroma with structural strength?

A

Collagens

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12
Q

What resides in the fibrous cap of atheroma?

A

Inflammatory cells (macrophages, lymphocytes, mast cells, etc)

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13
Q

Where are the cellular lipids from atheroma cores derived from?

A

Macrophages

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14
Q

What occurs in the late stage of plaque development that is used as as a marker for atherosclerosis in angiograms or CTs?

A

Dystrophic calcification

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15
Q

Where do atheromatous plaques usually form?

A

At arterial branching points (bifurcations)

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16
Q

What clinically complicates atheromas? (3)

A

Plaque rupturing
Thrombosis
Calcification into plaque

17
Q

What is the largest risk factor for atheroma?

A

Hypercholesterolaemia (excess of cholesterol in the blood stream)

18
Q

What are 4 biochemical signs of major hyperlipidaemia (high lipid levels in bloodstream)?

A

LDL (low density lipoproteins)
HDL (high density lipoproteins)
Total cholesterol
Triglycerides

19
Q

What are 2 physical signs of major hyperlipidaemia?

A

Corneal arcus

Xanthelasmata

20
Q

What are 2 medical risk factors for atheroma?

A

Hypertension

Diabetes mellitus

21
Q

What are 3 social risk factors for atheroma?

A

Smoking
Male
Elderly

22
Q

What are the 2 steps in the process of atheromatous plaque development?

A
  1. Endothelial lining of artery injured

2. Chronic inflammation and healing response of vascular wall

23
Q

What type of lipoprotein is responsible for atherosclerosis?

A

LDL

24
Q

What are 3 of the clinical consequences of the rupture of plaque leading to total occlusion?

A

MI
Stroke
Lower limb gangrene

25
Q

What aortic problem can arise from atheromatous ruptures?

A

Abdominal aortic anuerysm

26
Q

What are 5 lifestyle related therapeutic options to prevent consequences of atheroma?

A
Stop smoking
Control BP
Weght-loss
Exercise
Diet
27
Q

What 2 types of drug can be used to prevent consequences of atheroma?

A

Cholesterol lowering drugs

Asprin