MHD - Things to Know Week 1

Question 1

4 Modifiable risk factors of atherosclerosis

Answer 1

1. HTN
2. hyperlipidemedia (hypercholesterolemia)
3. Diabetes
4. Smoking

Question 2

Which layer of the coronary artery is predominantly affected by coronary artery atherosclerosis?

a. Tunica intima
b. Tunica Media
c. Tunica adventitia

Answer 2

Tunica Intima

Question 3

What are the 7 most common causes of disseminated intravascular coagulation (DIC)?

Answer 3

The five most common causes of DIC are (►mnemonic: STOP Making New Thrombi):

Sepsis – especially gram-negative

Trauma – especially to the central nervous system

Obstetric complications – especially preeclampsia, retained dead fetus, acute fatty liver of pregnancy

Pancreatitis (acute)

Malignancy – especially acute promyelocytic leukemia, mucinous tumors (gastric, ovarian, pancreatic), and brain tumors

Nephrotic syndrome

Transfusion reaction

Question 4

What are the two most important disorders predisposing to aortic aneurysms?

Answer 4

ATHEROSCLEROSIS

HYPERTENSION

• marfan, ehler danlos, vitamin C deficinecy, infection, tauma, congenital (berry aneurysm)

Question 5

What is the most common etiology of AAA?

How does it occur

Answer 5

ATHEROSCLEROSIS

• atheroma compress the aortic media, compromise nutrient and waste diffusion from the vascular lumen into the arterial wall
• medua undergoes degeneration & necrosis leading to overall arterial wall weakness an thinning

MMP (matrix metalloproteinase) production by inflammatory cell infiltrates involved in the pathogenesis of atherosclerosis play a key role

Question 6

What is the etiology of Aortic Dissection in 90% of cases?

Answer 6

HYPERTENSION!!

• contributing factors: pressure related mechanical or ischemic injury
• medial hypertrophy of vast vasorum
• degenerative changes of the media
• loss of smooth muscle cells
• connective tissue abnormality (medial degeneration –> MARFAN’s)