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Cardiorespiratory CC > Atherosclerosis > Flashcards

Atherosclerosis Flashcards

1
Q

3 Stages of Arteriosclerosis

A

Endothelial Damage
Uptake of modified LDL particles
Adhesion + infiltration of macrophages
Smooth muscle proliferation + formation of fibrous cap

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2
Q

Vasodilators

A

NO

PGI2

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3
Q

Vasoconstrictors

A

Angiotensin II

Endothelin

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4
Q

Fibrinolysis

A

Process that prevents blood clots

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5
Q

Endothelium dysfunction

A

Imbalance between vasodilating + vasoconstricting substances

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6
Q

Endothelium Damage causes

A 
Shear stress
Toxic damage
High lipid levels
Viral/bacterial infection
Dysfunctional damaged endothelium
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7
Q

Lipoproteins

A

Lower the density of a lipoprotein, the more lipid it contains relative to protein

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8
Q

Lowest to highest density lipoprotein

A

Chylomicron –> VLDL –> IDL –> LDL –> HDL

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9
Q

Chylomicron Main component + Apoprotein

A

TG

B48 (A,C,E)

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10
Q

VLDL Main component + Apoprotein

A

TG

B100 (A,C,E)

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11
Q

IDL Main component + Apoprotein

A

TG + cholesterol

B100, E

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12
Q

LDL Main component + Apoprotein

A

Cholesterol

B100

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13
Q

HDL Main component + Apoprotein

A

Protein

AI, AII (C,E)

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14
Q

Biggest Lipoprotein –> smallest

A

Chylomicron –> VLDL –> IDL –> LDL –>HDL

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15
Q

Oxidation of LDLs

A

Facilitated by reactive O2 species (free radicals)
Decreased by antioxidants in fruit + veg
Stimulates expression of inflammatory mediators including adhesion molecules

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16
Q

Glycation of LDLs

A

High glucose levels
Higher glycated LDLs in diabetes
Glycated LDL more likely to get oxidised

17
Q

Infiltration of macrophages

A

Endothelial Damage/oxidised LDLs –> attract monocytes
Monocytes bound to/cross endothelium
Transformed into macrophages –> accumulate oxidised LDLs
Fat-laden foam cells appear as fatty streaks

18
Q

Normal LDL uptake

A

LDL receptor recognises B100
Internal accumulation of LDL by macrophages
Lower LDL surface receptors –> lower uptake

19
Q

Modified LDL uptake

A

Modified LDL not recognised by LDL receptor
Instead taken up via scavenger receptor
NO negative feedback
LDL accumulates in large droplets- FOAM CELLS

20
Q

Fibrous cap formation

A 
Damage to Endothelium
LDL oxidation + entry
Taken up by macrophages
Lipid filled foam cells
Create subendothelial pool
Cytokines secreted by endothelium + macrophages stimulates migration of SMC
Secrete collagen forming a fibrous cap
Rupture can lead to thrombus formation
21
Q

Stable Plaque

A

Slow growing
Fibrin cap matures (not prone to rupture)
Reduced blood flow
Stable angina (exertional)

22
Q

Unstable Plaque

A 
Grow quickly - rapid lipid deposition
Thin fibrin cap
Fragile cap ruptures 
Thrombus formation
Reduced lumen diameter
May occlude lumen completely (MI)
23
Q

Fragile cap rupture

A

Haemorrhage from plaque
Release of platelet tissue factor (clotting cascade)
Collagen exposed causing platelet aggregation

24
Q

Total cholesterol adult

A

under 200mg/dl

25
Q

LDL adult

A

Under 130 mg/dl

26
Q

HDL adult

A

over 40mg/dl

27
Q

triglyceride range

A

10-190 mg/dl

28
Q

Homocystinaemia

A

RF for unstable plaque
Increased homocysteine (B6, B12 + folic acid deficiencies)
Increase oxidant stress
Need to up B vitamin intake to combat

29
Q

B vitamin uptake pathway

A

Methionine –> homocysteine in bloodstream
Homocysteine –> cysteine (B6) (cell folding/antioxidant)
Homocysteine –> back to methionine (B12)

30
Q

Lipoprotein (a)- LDL + extra apolipoprotein

A

RF for unstable plaque

More firmly retained in arterial wall

31
Q

Infection

A

Unstable plaque RF
Chlamydia pneumoniae
inflammation of endothelium

32
Q

Treatment Unstable Plaques

A

Modifiable risk factors
Statins
Polypill

33
Q

Statins MOA

A 
Inhibit HMG CoA
Decrease cholesterol in liver cells
increase uptake from circulating blood plasma
increase LDL receptors
decrease plasma cholesterol
34
Q

Polypill

A 
More than 80% CV disease reduction
Statin 
x 3 BP lowering drugs (thiazide, B blocker, ACE inhibitor)
B vitamins
Aspirin
35
Q

Atherosclerosis Complications

A 
Coronary Artery disease (Angina, MI)
Peripheral vascular disease (ulcers)
Stroke
aneurysm
renal artery stenosis
36
Q

Stent

A

Maintains patency of blood vessel

Cardiorespiratory CC (34 decks)

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