cholesterol, atheroma, CHD Flashcards Preview

Sem 2 > cholesterol, atheroma, CHD > Flashcards

Flashcards in cholesterol, atheroma, CHD Deck (63):
1

LDL levels are raised by (3)

cigarette smoking, coffee, stress

2

Majority of cholesterol is

LDL

3

Cholesterol largely responsible for atheroma formation

LDL

4

Cholesterol which prevents atheroma

HDL

5

Functions of cholesterol (6)

lipid precursor for other steroids, important in cell growth and division, regulation of sexual function, regulation of tissue metabolism, mineral balance and formation of bile salts

6

proportion of cholesterol made in liver

1/4

7

cholesterol is poorly absorbed by

gut

8

cholesterol is carried in blood as part of

lipoprotein

9

HDL formation begins in

liver

10

HDL begins as

empty collapsed protein shell

11

HDLs travel in blood picking up

cholesterol and phospholipids

12

After picking up cholesterol and phospholipids, HDL

returns to liver and cholesterol is removed

13

chylomicrons form in

absorptive cells of small intestine

14

chylomicrons travel from small intestine through ..... to blood

lymphatic system

15

chylomicrons are hydrolysed to monoglycerides and free fatty acids to travel through capillary walls into adipocytes before being resynthesised into

triglycerides

16

VLDLs are produced by

liver

17

VLDLs transport lipids to adipose tissue for storage where they become

LDLs

18

liver compensates for ............. of cholesterol

dietary intake

19

changes in diet can reduce serum cholesterol by

5% max

20

Fatty acid intake can reduce cholesterol level by

15-20%

21

2 other forms of synthesis of cholesterol

glycolysis (acetyl CoA) or beta-oxidation of other lipids

22

exercise reduces sensitivity of right atrium to ........ and so heart secretes less ...... and blood volume ...... meaning more cholesterol is transported by HDLs to .......

blood pressure; atrial natriuretic peptide; increases; liver

23

familial hypercholesterolaemia due to (2)

low number LDL receptors, altered function/structure of receptors

24

familial hypercholesterolaemia is most common type of ......... (1/500)

hyperlipidaemia

25

in familial hypercholesterolaemia, LDL levels are in excess of

190

26

LDL receptor gene on chromosome

19

27

familial hypercholesterolaemia alleles exhibit

incomplete dominance

28

symptoms of familial hypercholesterolaemia (5)

xanthomas, xanthelasmas, arcus senilis, obesity, symptoms of atherosclerosis

29

xanthoma =

fatty, cholesterol-rich deposits in skin

30

xanthelasma =

fatty deposits on eyelid

31

arcus senilis =

white ring around cornea

32

atheroma =

accumulation of intracellular and extracellular lipid in INTIMA of large and medium arteries

33

3 stages of atheroma formation

fatty streak, simple plaque, complicated plaque

34

arteriosclerosis =

thickening of arterial walls, usually due to diabetes / hypertension

35

causes of atherosclerosis (5)

high BP, high cholesterol, smoking, high blood sugar, heart disease - angina

36

risk factors of atherosclerosis (15)

smoking, male, menopause, diet, alcohol, obesity, familial hyperlipidaemia, acquired hyperlipidaemia, diabetes, lack of exercise, type A personality, stress, infection, soft water, oral contraceptives

37

ATHEROMA FORMATION: (1) micelles absorbed into intestinal mucosa > converted to ......

chylomicrons

38

ATHEROMA FORMATION: (2) chylomicrons absorbed by ......... and travel through thoracic duct to be distributed throughout the body

lacteals

39

ATHEROMA FORMATION: (3) ............ .......... hydrolyses chylomicrons into fatty acids and monoglycerides which are released into intestinal fluid to be absorbed by adipocytes and skleletal muscle

lipoprotein lipase

40

ATHEROMA FORMATION: (4) liver absorbs chylomicron and removes triglyceride > combines with ........... (alters surface protein)

cholesterol

41

ATHEROMA FORMATION: (5) Capillary endothelial cells contain LDL receptors and absorb LDLs in .......... coated vesicles

clathrin

42

ATHEROMA FORMATION: (6) Excess levels of cholesterol inhibit cholesterol and LDL receptor synthesis > LDL uptake reduced > cholesterol ......... promoted

storage

43

ATHEROMA FORMATION: (7) Circulatory monocytes remove .......... and become saturated with ............ droplets

lipoproteins; lipid

44

ATHEROMA FORMATION: (8) Saturated monocytes form ..... cells which attach to endothelial walls of blood vessels

foam

45

ATHEROMA FORMATION: (9) Once foam cells attached to endothelial walls of blood vessels, they release cytokines which stimulate stimulate smooth muscle cells near the tunica ............ to divide causing the walls to thicken

intima

46

ATHEROMA FORMATION: (10) Other monocytes invade the area and ........... lipids forming an atherosclerotic ....... and ........

phagocytise; plaque; stenosis

47

LDLs secrete ....... which prevents normal migration of macrophages out of arteries

netrin-I

48

coronary atherosclerosis is a complex ........ process

inflammatory

49

coronary atherosclerosis is the accumulation of lipids, macrophages and ...... ......... cells

smooth muscle

50

ATHEROGENESIS: (1) atherogenesis follows endothelial ........ with increased permeability to and accumulation of .......... lipoproteins

dysfunction; oxidised

51

ATHEROGENESIS: (2) oxidised lipoproteins taken up by macrophages at .......... ..... within endothelium

focal sites

52

ATHEROGENESIS: (3) these macrophages form lipid-laden ..... ...... which form a fatty .....

foam cells; streak

53

ATHEROGENESIS: (4) fatty streak progresses with extracellular lipid within endothelium to form a ............ plaque

transitional

54

ATHEROGENESIS: (5) monocytes, macrophages and damaged endothelium release ..... which promote further accumulation of macrophages and smooth muscle cell migration and ..........

cytokines; proliferation

55

ATHEROGENESIS: (6) collagen is produced in large quantities by ......... .......... and events accumulate finally forming a ......... ........

smooth muscle; fibrolipid plaque

56

There are two mechanisms a thrombosis can develop on a plaque:

superficial endothelial injury, deep endothelial fissuring

57

superficial endothelial injury = denudation of endothelial covering of plaque exposing the subendocardial .... ....... .......... and allowing platelet adhesion due to reaction with .....

connective tissue matrix; collagen

58

deep endothelial fissuring = advanced plaque with ..... core formed because plaque cap tears allowing .... to enter. Core now has lamellar lipid surfaces, ...... ...... produced by macrophages and exposed ..... which makes it highly .....

lipid; blood; tissue factor; collagen; thrombogenic

59

total cholesterol ratio should not exceed

5

60

ideal cholesterol ratio

1.0-3.5

61

when calculating cardiovascular risk, what is cut off for high risk?

20+%

62

when calculating cardiovascular risk, what is cut off for moderate risk?

10-20%

63

when calculating cardiovascular risk, what is cut off for low risk?

<10%