MoD Session 6- Atheroma Flashcards Preview

SOPHIE'S ESA 2 > MoD Session 6- Atheroma > Flashcards

Flashcards in MoD Session 6- Atheroma Deck (39)
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0
Q

Define atherosclerosis

A

A hardening and thickening of arterial walls as a result of atheroma.

1
Q

Define atheroma

A

An accumulation of intracellular and extracellular lipid in the intima and media of large and medium sized arteries.

2
Q

Define arteriosclerosis

A

A hardening and thickening of artery and arteriole walls as a result of hypertension and DM.

3
Q

What are the 3 macroscopic features of atheroma?

A
  1. Fatty streak
  2. Simple plaque
  3. Complex plaque
4
Q

What is a fatty streak?

A

A yellow, raised lipid deposit in the intima.

5
Q

What is a simple plaque?

A

A yellow/white raised, widely distributed deposit.

6
Q

How does a complex plaque form?

A

By the enlargement and coalescing of simple plaques.

7
Q

What are the complex plaque complications? (4)

A

Calcification, thrombosis, haemorrhage and aneurysm formation.

8
Q

What are the 5 common sites of atheroma formation?

A
  • aorta (abdominal)
  • carotid arteries
  • cerebral arteries
  • leg arteries
  • coronary arteries
9
Q

What are the 3 early microscopic features of atheroma?

A
  • smooth muscle cell proliferation
  • foam cell accumulation (phagocytosis of lipids)
  • extracellular lipid deposition
10
Q

What are the 5 later microscopic features of atheroma?

A
  • fibrosis and necrosis
  • cholesterol clefts
  • disrupted internal lamina which extends into media
  • in growth of blood vessels
  • plaque fissuring
11
Q

What is the difference between angina and an MI?

A

If you stop what is causing the pain, in angina the pain will go away, whereas it will not in an MI.

12
Q

Define infarction

A

Obstruction of the blood supply to an organ or tissue causing local death of the tissue.
Typically by a thrombus/embolus

13
Q

Define Ischaemia

A

An inadequate blood supply to an organ.

14
Q

Define aneurysm

A

A excessive, localised swelling of the wall of an artery.

15
Q

Name 5 clinical effects of atheroma

A
  • cerebral Ischaemia
  • ischaemic heart disease
  • mesenteric Ischaemia
  • peripheral vascular disease
  • abdominal aortic aneurysm
16
Q

5 things ischaemic heart disease can cause

A
  • angina pectoris
  • MI
  • arythmias
  • cardiac failure
  • sudden death
17
Q

How does a cerebral infarction/stroke come about in cerebral Ischaemia?

A

Atherosclerosis in carotid arteries
Thrombus and then embolus formation
Embolus occludes cerebral arteries
Stroke

18
Q

What 3 things can mesenteric Ischaemia cause?

A
  • ischaemic colitis
  • malabsorption
  • intestinal infarction
19
Q

What is intermittent claudication in peripheral vascular disease?

A

It is interval pain in calves due to exercise

20
Q

What is leriche syndrome?

A

It is claudication of the buttocks, and impotence

21
Q

What is ischaemic rest pain?

A

When there is claudication (due to artery obstruction) even when no exercise is being performed.

22
Q

Name 11 risk factors of atheroma

A
  • age
  • gender
  • hyperlipidaemia
  • smoking
  • hypertension
  • DM
  • alcohol
  • infection
  • geography
  • familial hypercholesterolaemia
  • apolipoprotein E genotype
23
Q

Which gender is more susceptible to atheroma formation?

A

Males

24
Q

What are associated physical signs of familial hypercholesterolaemia? (3)

A
  • xanthelasma
  • tendon xanthomas
  • arcus
25
Q

What are xanthelasmas?

A

Foam cell accumulations in the dermis

26
Q

What is corneal arcus?

A

A thin pale arc around the cornea of the eye that is cholesterol deposits

27
Q

What is the predicted link between hypertension and IHD?

A

That the higher pressure damages endothelial cells

28
Q

By what proportion does DM increase IHD risk by?

A

Doubles the risk

29
Q

What infections are associated with atheroma?

A
  • chlamydia pneumoniae
  • helicobacter pylori
  • cytamegalovirus
30
Q

What are the processes involved in atheroma formation? (4)

A
  • thrombosis
  • lipid accumulation
  • production of intercellular matrix
  • cell type interactions
31
Q

What are the 6 cell types involved?

A
  • endothelial cells
  • lymphocytes
  • neutrophils
  • platelets
  • macrophages
  • smooth muscle cells
32
Q

What is the function of endothelial cells?

A
  • haemostasis
  • collagen secretion
  • proliferation and migration stimulus for smooth muscle cells
33
Q

What is the function of platelets?

A
  • haemostasis

- proliferation and migration stimulus for smooth muscle cells

34
Q

What is the function of smooth muscle cells?

A
  • take up LDLs to become foam cells

- synthesise collagen and proteoglycans

35
Q

What is the function of macrophages?

A
  • phagocytosis of LDLs to become foam cells
  • oxidise LDLs
  • stimulate proliferation and migration of smooth muscle cells
36
Q

What is the function of neutrophils?

A

-secrete proteases that lead to continued local damage and inflammation

37
Q

What is endothelial injury due to? (3)

A
  • raised LDLs
  • hypertension
  • toxins
38
Q

What does endothelial injury cause? (3)

A
  • platelet adhesion and SMC proliferation
  • lipid accumulation and taken up by SMCs and macrophages
  • monocytes migration into the intima

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