Lecture 9- Atherosclerosis

Question 1

… dz is responsible for more morbidity and mortality than any other category of dz

Answer 1

vascular

Question 2

2 principle mechanisms of vascular dz

Answer 2

1. narrowing or obstruction of vasc. lamina

2. weakening of vasc. walls leading to dilation or rupture

Question 3

…. is a condition where there are calcifications in the muscular walls but there is no encroachment on lumen therefore usually clinically insignificant

Answer 3

Medial calcific sclerosis (Monckebergs)

Question 4

2 types of arteriosclerosis that affect arterioles

Answer 4

1. hyaline

2. hyperplastic

Question 5

hyaline arteriosclerosis is seen in … and …

Answer 5

HTN

diabetes

Question 6

hyperplastic arteriosclerosis is seen in

Answer 6

malignant HTN

Question 7

atherosclerosis affects…

Answer 7

larger arteries

Question 8

atherosclerosis is associated with the formation of …. called…. which protrude into the lumen

Answer 8

intimal lesions

atheromas (atheromatous or atherosclerotic plaques)

Question 9

atheromas can…. and obstruct blood flow, may weaken the underlying … of the artery and can also rupture resulting in catastrophic …

Answer 9

enlarge
media
vessel thrombosis

Question 10

High prevalence of atherosclerosis is seen in… and low prevalence is seen in…

Answer 10

U.S., western Europe

Africa, far east

Question 11

The peak death rate from MI was ….% in the late 1960s

Answer 11

54%

Question 12

The current death rate is about …% for all atherosclerotic related complications (…% due to MI)

Answer 12

50%

25%

Question 13

3 non-modifiable risk factors of atherosclerosis

Answer 13

genetics- family history
increasing age
being male

Question 14

4 modifiable risk factors for atherosclerosis

Answer 14

diabetes
hypercholesterolemia
cigarette
HTN

Question 15

6 additional rick factors of atherosclerosis

Answer 15

1. inflammation
2. hyperhomocysteinemia
3. lipoprotein(a)
4. metabolic syndrome (obesity)
5. Type A personality
6. lack of exercise

Question 16

3 components of atherosclerosis response to injury hypothesis

Answer 16

1. endothelial injury
2. accumulation of lipoproteins
3. monocyte adhesion

Question 17

fatty streaks appear in most children independent of … and occurs at both sites prone and not prone to atherosclerosis. some may progress to…

Answer 17

geography, gender, race and environment

atheromas

Question 18

5 complications of atherosclerosis

Answer 18

ischemic heart disease (MI)
cerebral infarct
gangrene
renal artery stenosis
aoritc aneurysm

Question 19

HTN affects approx. …. % of the US population

Answer 19

25%

Question 20

severe HTN is over

Answer 20

160/106

Question 21

symptoms of HTN (none at low and moderate)

Answer 21

headache
fatigue
dizziness
palpitations

Question 22

… HTN accounts for 90-95% of all patients with HTN

Answer 22

essential

Question 23

6 contributing factors of essential hypertension

Answer 23

genetics
obesity
inactivity
stress
high salt intake
smoking

Question 24

…. hypertensive heart disease is when L. ventricular concentric hypertrophy provides normal CO

Answer 24

compensated

Question 25

... hypertensive heart disease is when the hypertrophy is no longer adequate to provide normal CO due to decreased myocardial contractility resulting in LV dilation and gradual onset of CHF

Answer 25

decompensated

Question 26

... is thickening of the L. ventricular wall at the expense of the L. ventricular chamber with little or no increase in the outside cardiac dimensions

Answer 26

concentric hypertrophy

Question 27

.... hypertension has a relatively rapid onset, is often superimposed on previous HTN , and has very high systolic and diastolic pressures

Answer 27

accelerated malignant

Question 28

5 complications of accelerated malignant HTN

Answer 28

1. cerebral edema 2. papilledema 3. encephalopathy 4. renal failure 5. cerebral hemorrhage