Atherosclerosis

Question 1

underlying cause of all stages of atherosclerosis

Answer 1

endothelial dysfunction

Question 2

can affect many vascular beds

Answer 2

atherosclerosis

Question 3

rupture of atherosclerotic plaque

Answer 3

MI

Question 4

1st stage in atherosclerotic plaque formation

Answer 4

endothelial dysfunction

Question 5

decrease in NO
increase in selectins and integrins
monocytes in
EC apoptosis

Answer 5

endothelial dysfunction

Question 6

MCP-1

Answer 6

attracts monocytes

Question 7

M-CSF

Answer 7

attracts macrophages

Question 8

2nd stage of atherosclerotic plaque

Answer 8

formation of fatty streak

Question 9

platelets show up and aggregate
VSMC migration by PDGF
T cells show up
foam cell formation

Answer 9

formation of fatty streak

Question 10

VSMC migrate into endothelium by

Answer 10

PDGF and AngII

Question 11

macrophages unable to break down oxLDL

Answer 11

foam cell formation

Question 12

3rd stage in atherosclerotic plaque

Answer 12

formation of fibrous cap (advanced complicated lesions)

Question 13

VSMC grow over (fibrous cap)
necrosis and apoptosis from MMPs, ROS, oxLDL mediated cell damage

Answer 13

formation of advanced complicated lesions

Question 14

degrade matrix

Answer 14

MMPs (matrix metalloproteins)

Question 15

4th stage of atherosclerotic plaque

Answer 15

unstable plaque forms

Question 16

cap unstable–> rupture

Answer 16

unstable plaque

Question 17

what makes unstable plaque

Answer 17

VSMC’s die on surface and wall thins

Question 18

thin cap
MMP activity
VSMC death
lipid rich plaque

Answer 18

vulnerable plaque (unstable)

Question 19

thick cap
VSMC content high
low MMP activity
lipid poor plaque

Answer 19

stable plaque

Question 20

stable plaque consequences

Answer 20

angina and intermittent claudication (transient)

Question 21

unstable plaque consequences

Answer 21

MI
ischemic stroke
CV death

Question 22

endothelial dysfunction
dyslipidemia
inflammation
oxidative stress
PDGF, Ang II, AGEs
VSMC dysfunction
ECM remodeling

Answer 22

factors that promote atherosclerosis

Question 23

convert LDL to oxLDL

Answer 23

ROS and AngII

Question 24

what causes VSMC’s to switch from contractile to migratory and synthetic

Answer 24

AngII, AGE, PDGF

Question 25

inhibiting dyslipidemia does what to vascular wall

Answer 25

HDL prevents LDL to oxLDL, prevents expression of adhesion molecules, prevents foam cell formation

Question 26

reducing inflammation does what to vascular wall

Answer 26

no monocytes present (ultimately no foam cell formation)

Question 27

decreasing oxidative stress does what to vascular wall

Answer 27

NO stays nice and high; no ROS

Question 28

no ROS oxidative stress leads to what

Answer 28

no monocyte adhesion or migration into cell; no endothelial dysfunction

Question 29

decrease in endothelial dysfunction does what to vascular wall

Answer 29

NO normal (no EC death)
no monocytes, no platelet aggregation, no LDL oxidation

Question 30

place where people normally form atherosclerotic plaques due to change in laminar flow from bifurcation

Answer 30

carotid arteries

Question 31

decrease in PDGF, AGEs, and AngII does what to vascular wall

Answer 31

STOPS CAP FORMATION
VSMC stays contractile

Question 32

this is involved in all the steps of atherosclerosis, so if you block this, you won’t get plaque formation

Answer 32

AngII

Question 33

drug used to lower AngII

Answer 33

Ramapril (ACEI)

Question 34

increase in VSMC and decrease in ECM remodeling effect on vascular wall

Answer 34

no cap formation
no rupture b/c no MMP activity

Question 35

drug that blocks AT1R

Answer 35

Telmisartan

Question 36

AT1R

Answer 36

AngII receptor (ARB)

Question 37

successful drugs to decrease CV disease

Answer 37

Ramapril and Telmisartan

Question 38

decrease LDL and CRP=

Answer 38

decrease risk for CV disease