Cardiovascular Disease

Question 1

What is atherosclerosis

Answer 1

buildup of plaque in the artieries

Question 2

What does the fibrous cap do?

Answer 2

protects the plaque build-up

Question 3

Fatty deposit (aka plaque)

Answer 3

Fats, cholesterol, and other substances build up in the artery wall

Question 4

Vulnerable plaques

Answer 4

susceptible to rupture due to high lipid content, increased inflammation, and thin fibrous cap

Question 5

plaque inflammation and increased arterial pressure can trigger______

Answer 5

plaque rupture

Question 6

When plaque ruptures, exposure to blood flow triggers _____

Answer 6

A thrombus

Question 7

Thrombus

Answer 7

blood clot consisting of platelets and insoluble fibrin forms at the site of injury

Question 8

Myocardial infarction (heart attack)

Answer 8

occurs when a clot completely blocks blood flow to an area of the heart

Question 9

Heart tissues die when ___

Answer 9

oxygen (supplied by blood) is denied to the tissues

Question 10

Steps to plaque formation

Answer 10

1. Arterial wall damage
2. Chemokines secretion
3. Foam cell formation
4. SMC migration

Question 11

What happens when the arterial wall is damaged?

Answer 11

LDL enters the blood stream and then LDL is oxidized and retained

Question 12

What happens when LDL is oxidized?

Answer 12

Endothelial cells are activated secreting chemokines and then monocytes adhere to receptors ICAM and VCAM

Question 13

Endothelial cell activation leads to :

Answer 13

• Adhesion is molecularly activated
• Secrete chemokines

Question 14

How are foam cells formed?

Answer 14

monocytes differentiate into macrophages which are then filled with LDL

Question 15

What is a foam cell?

Answer 15

macrophage filled w/ LDL

Question 16

What causes SMC’s to proliferate?

Answer 16

Foam cells secrete growth factors that tells the SMCs to multiply

Question 17

What causes the SMC’s to migrate?

Answer 17

OxLDL binds to the proliferated cells and this causes the release

Question 18

What do the SMC’s do when they are released?

Answer 18

they begin extracellular matrix formation which is comprised of proteins such as collagen and elastin.

Question 19

How should the fibrous cap form?

Answer 19

Slowly

Question 20

What happens if the fibrous cap forms quickly?

Answer 20

the cap doesn’t form well and its likely to rupture

Question 21

Intima

Answer 21

the area between SMC’s and EC’s

Question 22

When subendothelial proteins are exposed, this leads to _____

Answer 22

Thrombosis

Question 23

What is bad cholesterol

Answer 23

LDL- low density lipid protein

Question 24

What is good cholesterol

Answer 24

HDL- High density lipid protein

Question 25

HDL function

Answer 25

moves cholesterol from the body to the liver for clearance (removes cholesterol)

Question 26

LDL function

Answer 26

moves cholesterol to arteries

Question 27

Why is HDL more dense than LDL?

Answer 27

More protein per lipid

Question 28

WHat do statins do?

Answer 28

they inhibit HMG=CoA reductase, which is the rate-limiting step of CHolesterol synthesis

Question 29

Statins ____ and they increase the ____ in the liver which decreases _____

Answer 29

reduce cholesterol synthesis LDL receptors LDL by 25%-50%

Question 30

Vascular grafts are usually made of _____ and are only useful for ______

Answer 30

polymers large arteries

Question 31

Vascular grafts are coated with ____ which _____

Answer 31

heparin prevents clotting

Question 32

How are stents implanted

Answer 32

1. stent is inserted into the artery 2. The stent is expanded via a balloon 3. The balloon is removed and the stent remains expanded in the artery

Question 33

Stents are typically made of

Answer 33

metal coated with a polymer

Question 34

Biggest problem with stents and grafts is that ____

Answer 34

they tend to form a thrombus

Question 35

Types of anticoagulant coatings

Answer 35

Hirudin Heparin

Question 36

TFPI and Thrombodulin both _____

Answer 36

Inhibit binding process of thrombin

Question 37

Albumin is ____

Answer 37

protein that prevents things from binding

Question 38

GAGs are

Answer 38

(glycose amino glycans) found on the surface of EC's and prevents platelet binding

Question 39

PC is

Answer 39

a phospholipid found in cell membrane that inhibits platelet binding

Question 40

PEG can

Answer 40

prevent platelet binding

Question 41

EC's release nitric oxide which ____

Answer 41

inhibits platelet binding and SMC proliferaiton

Question 42

Tissue engineered vascular grafts process

Answer 42

1. Cells extracted from patient 2. Cells expanded in culture 3a. Cells mixed with polymer scaffold material and shaped in mold 3b. Vells seeded into porous polymer scaffold 4. COnstruct matured in a bioreactor

Question 43

Nonthrombogenic engineering methods

Answer 43

1. Anticoagulant coatings 2. Inhibit platelet adhesion/ activation 3. In vitro endothelialization 4. In situ endothelialization