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Flashcards in Cardiovascular Risk Factors Deck (68)
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1

Name a progressive disease that is characterised by a buildup of plaque within the arteries?

Atherosclerosis

2

What 5 substances form plaque?

1. Fatty substances
2. Cholesterol
3. Cellular waste
4. Calcium
5. Fibrin

3

What two things can happen to a plaque (atherosclerosis) and what does that lead to?

1. Bleeding into the plaque
2. Formation of a clot on the surface of the plaque

Heart attack or stroke

4

What is the term used to describe the formation of an acute thrombus in a vessel affected by atherosclerosis, a process common to a number of CV disorders?

Atherothrombus

5

What is the atherothrombotic process initiated by?

Changes in vessel wall resulting from plaque disruption

6

What components can the atherosclerotic plaque expose when it becomes unstable and ruptures?

Collagen and von Willebrand factor

7

What two substances allow platelets to adhere to the damaged area and initiate thrombus formation?

Collagen
Von Willebrand factor

8

What can a thrombus extending and occluding the vessel lead to?

Acute ischaemia and tissue injury

9

What is the term for thrombosis superimposed on atherosclerosis?

Atherothrombosis

10

What three conditions can result if there is a fibrous plaque, atherosclerotic plaque?

1. Angina
2. Transient ischaemic attack
3. Claudication/PAD

11

What might cause ischaemia in distal vascular beds?

Embolisation of platelets or fibrinous material from ulcerated plaques

12

What are the clinical effects of atheroma in retinal arteries?

Imparied vision

13

What are the two clinical effects of atheroma in renal arteries?

Hypertension and renal failure

14

What are the clinical effects of atheroma in mesenteric arteries?

Mesenteric ischaemia

15

What are the two clinical effects of atheroma in femoral arteries?

Claudication
Gangrene

16

What are the two clinical effects of atheroma in aorta/iliac arteries?

Intermittent claudication
Gangrene

17

What are the clinical effects of atheroma in coronary arteries?

Ischaemic heart disease

18

What are the two effects of clinical atheromas in the cerebral/carotid arteries?

Transient ischaemic attack
Strokes

19

In the pathogenesis of atherosclerotic plaques: what protective response results after endothelial damage?

Production of cellular adhesion molecules

20

What can these factors all potentially cause - hypertension, vasoactive substances, mediators (cytokines) from blood cells, cigarette smoke, atherogenic diet, elevated glucose levels and oxidised LDL-C?

Damage to endothelium of arterial walls resulting in endothelial dysfuncion

21

Name two cytokines expressed by endothelila cells after vessel damage?

1. IL-1
2. TNFalpha

22

What three chemokines are expressed by endothelial cells after damage to vessel walls?

1. Monocyte chemoattractant factor
2. MCP-1
3. IL-8

23

What two growth factors are expressed by endothelial cells as a result of vessel damage?

1. Platelet-derived growth factor PDGF
2. Basic fibroblast growth factor BFGF

24

What is decreased by endothelial cells, as a response to oxidative stress in the vessel wall?

Production of NO, a vasodilator

25

What two substances are increased by endothelial cells, as a result of opxidative stress in the vessel wall?

Endothelin
Angiotensin II

26

What two local mediators are increased by endothelial cells, as a result of oxidative stress on the vessel wall?

1. Vascular cell adhesion molecule (VCAM)
2. Plasminogen activator inhibitor 1 (PAI-1)

27

What are the levels of HDL, LDL and triglycerides in dyslipidaemia?

HDL is low
LDL is high
Triglycerides are high

28

What are the big 4 CV risk factors?

1. High blood pressure
2. Hypercholesterolaemia
3. Smoking
4. Diabetes/obesity

29

Are VLDL and Chylomicrons atherogenic?

No

30

What carries cholesterol away from the arterial wall and is protective?

HDL

31

Which lipoproteins are the lowest in density, and biggest in size?

Chylomicrons

32

What lipoproteins are involved in the recycling of cholesterol by the liver as well as formation of LDL in blood?

IDL - intermediate-density lipoprotein

33

Which lipoprotein is strongly associated with atherosclerosis?

LDL

34

What is the normal triglyceride level and what does high triglyceride increase the risk of?

2.3 mmol/l
Pancreatitis

35

What is the exogenous metabolic pathway concerned with?

The transport and utilisation of dietary fats

36

What is the analogous particle that transports triglycerides from the liver to the rest of the body?

VLDL

37

During what process are triglycerides removed from the core and exchanged for cholesterol esters, prinipally from HDL?

Endogenous pathway of lipid metabolism

38

Is total cholesterol a modifiable risk factor?

Yes

39

What is the primary target (cholesterol) to prevent CHD?

LDL-C

40

What is xanthelasma a clinical marker for?

Dyslipidaemia

41

What are tendon xanthomas?

Diffuse infiltration of tendon by lipid

42

What are tuberous xanthomas?

Lipid deposits in the dermis and subcutis; papuler, nodular or plaques; extensor surfaces of large joints, hands, buttocks, heels and flexures

43

What two things can tuberous xanthomas be a sign of?

1. Familial or acquired hypertriglycerdemias
2. Biliary cirrhosis

44

What are eruptive xanthomas, and what do they indicate?

Small reddish/yellow papules found on buttocks, posterior thighs and body folds

Usually abrupt increase in serum triglyceride levels

45

What sign of dyslipidaemia can you find on palms?

Striate palmar xanthomas

46

What are the two types of hypertension?

1. Essential - no underlying cause
2. Secondary - underlying cause

47

What 5 substances can be included to diet to reduce obesity and CHD?

1. Micronutrients
2. Antioxidants
3. Omega 3 and 6
4. Polyuinsaturates
5. Monounsaturates

48

What type of diet protects against CHD and is rich in fruits, vegetables, fish, grains and beans?

Mediterranean

49

To achieve a diagnosis of metabolic syndrome, what characteristics msut a patient have 3 or more of (include values)?

1. Abdominal obesity
2. Triglycerides : > 1.7 mmol/l
3. HDL-C : 130/>85 mmHg
5. Fasting glucose : >5.6 mmol/l

50

What may homocysteine undergo remethylation to form, and what two substances does this process require?

Methionine
B12 and folic acid

51

What is used to assess a patients CV risk score?

Assign score

52

What is the most common cause of premature death?

Coronary heart disease

53

What are stenosis, thrombosis, aneurysm, dissection, embolism and ischaemia all complications of?

Atheroma

54

What involves narrowing of the arterial lumen, reduced elasticity, reduced flow in systole and tissue ischaemia?

Arterial stenosis

55

What leads to reduced exercise tolerance, angina, unstable angina, infarct and cardiac failure?

Cardiac ischaemia

56

Give 4 features of cardiac fibrosis?

1. Loss of cardiac myocytes
2. Replacement by fibrous tissue
3. Loss of contracility
4. Reduced elasticity and filling

57

What 4 arteries are mainly affected by arterial stenosis?

1. Coronary arteries
2. Carotid arteries
3. Renal arteries
4. Peripheral arteries

58

What are 3 results of arterial stenosis in the carotid arteries?

1. Transient ischaemic attack
2. Stroke
3. Renal failure

59

What are two results of arterial stenosis in renal arteries?

1. Renal failure
2. Hypertension

60

What are two results of arterial stenosis in peripheral arteries?

1. Claudication
2. Foot/leg ischaemia

61

What does plaque rupture often trigger?

Thrombosis

62

What can cause MI, cerebral infarction, renal infarction and bowel infarction?

Arterial thrombosis

63

What are the 4 features in aneurysm formation?

1. Annormal dilatation of artery
2. Weakening of media by atherosclerosis
3. Elastic degeneration and fragmentation-loss of stretch/recoil
4. Abdominal aorta

64

What are these causes of - congenital, berry aneurysm and subarachnoid haemorrhage, syphylitic, mycotic and iatrogenic?

Abnormal dilatation of artery

65

What are 3 complications of aneurysm?

1. Rupture
2. Thrombosis
3. Embolism

66

What are three features of arterial dissection?

1. Splitting within the media by following blood
2. False lumen filled with blood within the media
3. Sudden collapse

67

What is likely to occur in middle aged patients with/without atheroma?

Arterial dissection

68

What are these potential causes of - atheroma, hypertension, trauma, coarctation, marfan's and pregnancy?

Aortic dissection