Pathophysiology of atheroma

Question 1

define atheroma

Answer 1

it is a reversible accumulation of degenerative material in the inner layer of an artery wall

Question 2

what does the material in an atheroma consist of

Answer 2

mostly macrophage cells, or debris, containing lipids, calcium and a variable amount of fibrous connective tissue

Question 3

what is atheroma essentially

Answer 3

the degradation of the walls of the arteries caused by accumulated fatty deposits and scar tissue

Question 4

what does atheroma lead to

Answer 4

restriction of the circulation and a risk of thrombosis

Question 5

what can atheroma be basically classed as

Answer 5

the fat material which forms deposits in the arteries

Question 6

what coronary arterial disease

Answer 6

coronary heart disease is a disease in which a waxy substance called plaque builds up inside the coronary arteries

Question 7

what is the role again of the coronary arteries

Answer 7

they supply oxygen-rich blood to your heart muscle

Question 8

what is the role of atheroma in coronary arterial disease

Answer 8

when plaque builds up in the arteries, the condition is called atherosclerosis

Question 9

when does the build up of plaque occur

Answer 9

over many years

Question 10

what is cerebrovascular disease

Answer 10

it is a disease of the blood vessels, especially the arteries that supply the brain

Question 11

what is the role of atheroma in cerebrovascular arterial disease

Answer 11

cerebrovascular disease is usually caused by atherosclerosis and can lead to stroke

Question 12

what is peripheral artery disease

Answer 12

it is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs

Question 13

what occurs when you develop peripheral arterial disease

Answer 13

your extremities, usually your legs, don’t receive enough blood flow to keep up with demand

Question 14

what is the role of atheroma in peripheral arterial disease

Answer 14

peripheral arterial disease happens when your arteries become narrowed by a gradual build-up of fatty material within their walls

Question 15

what arteries are affected in peripheral arterial disease

Answer 15

it is nearly always the arteries in the lower part of the body, such as the legs, that are affected

Question 16

what is hyperlipidaemia

Answer 16

it is a disorder characterised by an abnormally high concentration of fats or lipids in the blood

Question 17

what are the 2 major types of lipids found in the blood

Answer 17

triglycerides and cholesterol

Question 18

when is the lipid triglyceride made

Answer 18

when your body stores the extra calories it doesn’t need for energy

Question 19

what is cholesterol

Answer 19

it is a lipid and is vital for the normal functioning of the body

Question 20

where is cholesterol made and found

Answer 20

it is made by the liver but can also be found in some foods

Question 21

what are the symptoms of hyperlipidaemia

Answer 21

most people will have no symptoms

Question 22

what is a complication of having hyperlipidaemia

Answer 22

having this disorder increases the risk of developing heart disease, it is a major risk factor

Question 23

what is the way to detect hyperlipidaemia

Answer 23

your doctor must perform a blood test called a lipid panel or a lipid profile, this is the only way to detect it

Question 24

what is a lipid panel

Answer 24

it is a test that determines your cholesterol levels

Question 25

what is considered high cholesterol levels

Answer 25

above 200mg per deciliter

Question 26

what will your doctor use to make a hyperlipidaemia diagnosis

Answer 26

your lipid panel

Question 27

what is atherogenesis

Answer 27

it is the process of forming atheroma, plaques in the inner lining of arteries

Question 28

what is atherogenesis essentially

Answer 28

a disorder of the artery wall

Question 29

what are atheromatous plaques

Answer 29

fatty deposits in the inner lining of an artery, resulting from atherosclerosis

Question 30

what are atheromatous plaques also called

Answer 30

atheromas

Question 31

what are the components of atheromatous plaques

Answer 31

plaques are made up of fat, cholesterol, calcium and other substances found in blood

Question 32

what is the core of atheromatous plaques consisting of

Answer 32

lipid-laden cells with elevated tissue cholesterol and cholesterol ester content, fibrin, proteoglycans, collagen, elastin and cellular debris

Question 33

what may atherosclerosis may be a result of

Answer 33

a specialised chronic inflammatory fibroproliferative process

Question 34

what do monocytes and lymphocytes adhere to?

Answer 34

the endothelial cell surface

Question 35

where to monocytes migrate to?

Answer 35

the sub endothelial space

Question 36

what do monocytes differentiate into

Answer 36

macrophages

Question 37

what does the ingestion of low density lipoproteins and modified or oxidised low density lipoproteins by macrophages lead to

Answer 37

the accumulation of cholesterol esters and formation of foam cells

Question 38

what do the foam cells form with the T lymphocytes?

Answer 38

the fatty streak

Question 39

describe the migration of vascular smooth muscle cells

Answer 39

vascular smooth muscle cells migrate from the media into the intima

Question 40

when do the vascular smooth muscle cells proliferate

Answer 40

with the formation of the atherosclerotic plaques

Question 41

what are the processes in atherogenesis regulated by

Answer 41

a complex network/cascade of cytokines and growth regulatory peptides

Question 42

what do the processes of atherogenesis involve

Answer 42

``` cell adhesion migration differentiation proliferation cell interaction with the extracellular matrix ```

Question 43

define an atheroma again

Answer 43

the formation of plaques in intima of large and medium-sized arteries

Question 44

what are serious consequences of atheroma

Answer 44

angina due to myocardial ischaemia

Question 45

what is atheroma complicated by

Answer 45

thromboembolism

Question 46

what does the narrowing of the lumen in the coronary arteries from the atheromatous plaques lead to

Answer 46

ischaemia

Question 47

where is atheroma

Answer 47

it is in the intima layer of the artery wall

Question 48

what are complications of atheroma

Answer 48

haemorrhage into plaque plaque rupture thrombosis

Question 49

what can also form on the plaque

Answer 49

thrombosis

Question 50

what is the most important risk factor of atheroma

Answer 50

hypercholesterolaemia

Question 51

what are risk factor for atheroma

Answer 51

``` smoking hypertension diabetes mellitus male elderly ```

Question 52

what are less strong risk factors of atheroma

Answer 52

obesity sedentary lifestyle low socioeconomic status low birthweight

Question 53

what are the preventative and therapeutic approaches of atheroma

Answer 53

``` stop smoking control blood pressure weight loss regular exercise dietary modifications ```

Question 54

what are the secondary preventions of atheroma

Answer 54

cholesterol lowering drugs | aspirin

Question 55

what is other therapy of atheroma

Answer 55

surgical options