Flashcards in B2.006 Acute MI Underlying Pathology Deck (28):
What is atherosclerosis?
intimal based lesion composed of a fibrous cap and atheromatous core (necrotic center)
What are some inherited/constitutional risk factors for atherosclerosis?
genetic, age, gender
What are some modifiable risk factors for atherosclerosis?
hyperlipidemia, hypertension, cig smoking, diabetes
What are the 5 main steps of atherosclerosis?
1. chronic endothelial "injury"
2.endothelial dysfunction and emigration
3. macrophage activation, smooth muscle recruitment
4. macrophages and smooth muscle cells engulf lipid
5. smooth muscle proliferation, collagen, and other extracellular matrix deposition, extracellular lipid
What causes hardening in plaques?
What is neovascularization?
blood vessels form within plaque, making the plaque susceptible to blood leakages and inflammation
What are some major sources of endothelial "injury"?
hyperlipidemia, hypertension, smoking, toxins, hemodynamic factors, immune rxns, viruses
What are the major structural components of a blood vessel?
lumen, endothelium, intima, internal elastic membrane, media, adventitia
What makes a plaque unstable?
thin fibrous cap, neovascularization, calcium deposits
What are the 3 primary clinical results of a vulnerable plaque?
aneurysm and rupture, occlusion by thrombus, and critical stenosis
What can cause an aneurysm?
mural thrombosis, embolization, wall weakening
What can cause occlusion by thrombus?
plaque rupture, plaque erosion, plaque hemorrhage, mural thrombosis, embolization
What can cause critical stenosis?
progressive plaque growth
What is the most common cause of death in the US?
What are 3 types of CAD?
MI, angina pectoris, sudeen cardiac death
What are consequences of atherosclerosis outside of the heart?
cerebrovascular disease, aneurysms, peripheral vascular disease
What is an anabolic circuit?
More intake, less expenditure
What is a catabolic circuit?
less intake, more expenditure
What types of circuits are associated with obesity?
What are 3 major consequences of obesity?
metabolic syndrome, type 2 diabetes, proinflammatory state
What is hyperinsulinemia and what is a risk factor and result of the condition?
persistently high level of insulin in the body, obesity is a risk factor, potent stimulation of cell proliferation is a result
What are some consequences of being in a proinflammatory state?
insulin resistance, hyerinsulinemia, hypertension, CAD, nonalcoholic fatty liver disease
How does insulin resistance affect free IGF?
How does insulin resistance affect apoptosis?
What is inflammation?
response of vascularized tissue to infection or injury
What are the two types of inflammation?
acute and chronic
Describe acute inflammation.
initial rapid response to infection/tissue damage
increased blood flow
increased vascular permeability
emigration of primarily neutrophils to site
results in healing by fibrosis, resolution, or progression to chronic inflammation