Atherosclerosis and peripheral vasc disease

Question 1

Modifiable risk factors of atherosclerosis?

Answer 1

smoking
lipid intake
BP
diabetes
obesity
sedentary lifestyle

Question 2

What are non-modifiable risk factors atheroscleorsis?

Answer 2

Age
Sex
Genetic background

Question 3

ABCD? Do decide which med to give

Answer 3

Ace inhibitors
Beta blockers
C
Diuretics

Question 4

What can be given for obestiy?

Answer 4

Weight loss
gastric surgert
metformin 
insulun 
dietry advice

Question 5

What has reduced hyperlipidaemia over the last decade?

Answer 5

statin treatment

Question 6

What has reduced hypertension over the last decade?

Answer 6

antihypertensive treatment

Question 7

What has increased diabetes in the last decade?

Answer 7

Increased obesity

• New improvements in diabetes treatment have doubtful effect on macrovascular disease

Question 8

Which vessels are affected most by atheroscleorisis?

Answer 8

Coronary
Cerebral
Carotid
Iliac

tend to occur in bifurcations, branches, bends due to turbulent blood flow. This can cause inflammation

Question 9

What is LDL deposition?

Answer 9

Atherescleorsis happens in between the internal elasric and intima usding LDL dposition

Question 10

How doe LDL bind?

Answer 10

depost in subintimal space and binds to matrix proteoglycans

Question 11

Describe the progression of atherosclerosis?

Answer 11

…

Question 12

When is the window of opportunity for primary prevention?

Answer 12

….

Question 13

When is clinical intervention eeded?

Answer 13

….

Question 14

What is the role of vascular smooth. muscle cells?

Answer 14

…

Question 15

What are vascular endothelial cell for?

Answer 15

…

Question 16

What are Platelets for?

Answer 16

///

Question 17

What are T lymphocytes for?

Answer 17

…

Question 18

What did the cantos trial show?

Answer 18

Inflammation involved in atherosclerosis:

px at high risk injected with antibodies to IL-1

lead to fewer major adverse cardiovascular events - MACE

Multiple mechanisms including cholesterol crystal formation connect lipids and inflammation in atherosclerosis

Question 19

what did zohaa say to jiya on 3/12/21 10:29?

Answer 19

im gonna be so lonely stuck in reynolds u better or i will replace u with the better rashid

Question 20

what did zohaa say to jiya on 3/12/21 10:29?

Answer 20

im gonna be so lonely stuck in reynolds u better or i will replace u with the better rashid

Question 21

macro

Answer 21

ysdsf

Question 22

WHat two classes of macrophages are therw?

Answer 22

inflammatory

resident

Question 23

How are macrophage subtypes regulated?

Answer 23

combinations of transcription factors binding to regulatory sequences

Question 24

Why is white blood cell regulation vital?

Answer 24

cells can injure host tissue if they are activated excessively or inappropriately!

Question 25

WHich are the main inflammatory cells in atherosclerosis?

Answer 25

macrophages

Question 26

What do inflmmatory macrophages do?

Answer 26

Adapted to kill microorganisms (germs)

Question 27

Which resident macrophages are thee?

Answer 27

normal homeostatic - suppress inflammatory activity alveolar resident macrophages - surfactant lipid homeostasis osteoclasts - keep Ca + Phosphate under tight regulation spleen - takes abnormal, old RBCs out of the blood

Question 28

Which resident macrophages are thee?

Answer 28

normal homeostatic - suppress inflammatory activity alveolar resident macrophages - surfactant lipid homeostasis osteoclasts - keep Ca + Phosphate under tight regulation spleen - takes abnormal, old RBCs out of the blood *old rbc get stiff and stuck in narrow vessels of spleen == iron homeostasis

Question 29

What are LDLS, where are they made and taken?

Answer 29

.

Question 30

What are HDLs, what does it do?

Answer 30

.

Question 31

What are oxidised LDLs, modified LDLs?

Answer 31

.

Question 32

describe the structure of an LDL?

Answer 32

Centre : cargo fat for fuel, TG and CE surrounded by lipid monolayer cholesterol in membrane apoprotein on top

Question 33

How are oxidised LDLs made?

Answer 33

LDLs leak through th endothelial barrier LDL binds to maxtric proteoglycans in subendothelial layer = becomes susceptible to modification LDL becomes oxidatively modifited by free radicals

Question 34

How do macrophages cause chronic inflammation via LDLs?

Answer 34

Oxidised LDLs are phagocytosed by macrophages and stimulates chornic inflammatipn

Question 35

WHat are foam cells?

Answer 35

When macrophage has take up LDLs

Question 36

What is familial hyperlipidemia?

Answer 36

- Autosomal genetic disease - Massively elevated cholesterol (>~20 mmol/L). (effective ‘normal’ ~1-5 mmol/L) Failure to clear LDL from blood. = Xanthomas and early atherosclerosis; if untreated fatal MYOCARDIAL INFARCTION before age 20.

Question 37

slide 24?

Answer 37

24

Question 38

macrophage receptor A?

Answer 38

//

Question 39

/macrophage receptor B\?

Answer 39

//

Question 40

WHich enzymes do macrophages have?

Answer 40

ocidative: NADPH oxidase Myeloperoxidase e.g.HOCl ...

Question 41

How are monocytes recruited?

Answer 41

Plaque macrophages express inflammatory factors that are involved in monocyte recruitment.

Question 42

Which cytokines are involved with self perpetuating inflammation?

Answer 42

..

Question 43

Which chemokines are involved with self perpetuating inflammation

Answer 43

..

Question 44

What do VSMC do?

Answer 44

...

Question 45

How are VSMC recruited?

Answer 45

//

Question 46

What is platelet dderived growth factor used for?

Answer 46

...

Question 47

WHat does the transforming grwoth factor beta?

Answer 47

..

Question 48

How do normal medial vascularr smooth muscles become atherosclerotic?

Answer 48

...

Question 49

What are metalloproteinases? (expressed by mcarophaes)

Answer 49

Family of ~28 homologous enzymes. Activate each other by proteolysis. Degrade collagen. Catalytic mechanism based on Zn.

Question 50

What are the effects of plaque erosion?.

Answer 50

Blood coagulation at the site of rupture may lead to an occlusive thrombus and cessation of blood flow.

Question 51

What are the chatacteristics of a vulnerable plaque which can become ruptured?

Answer 51

//

Question 52

describe macrophage apoptosis?

Answer 52

..

Question 53

What is the nuclear factor Kappa B?

Answer 53

TF

Question 54

How does NFkB coregulate different inflammatory genes?

Answer 54

,,