Biochem Final Nts Artherosclerosis

Front 1

what will a diest high in omega 3 reduce the risk of? will it affect platelet aggregation or coagulation

Back 1

v fib

Decrease platelet aggregation

Front 2

intima
media
adventitia

Back 2

layers of vessels

intima: endothelium, lines lumen: elastic, proteoglycans, collagen
Media: Smooth MM
Adventitia: CT,

Front 3

what are 4 fx of healthy endothelium

Back 3

1. dilation
2. inhibit coagulation: inhibit clot formation, inhibit platelet activation, stimulat fibrinolysis
3. inhibit imflammation
4. Inhibit migration/differentiation of: monocytes, T cells, VSM (vascular SM)

Front 4

name 3 ways healthy endo prevents coagulation

Back 4

1. inhibit clot formation
2. inhibit platelt activation
3. stimulate fibrinolysis

Front 5

what does healthy endothelium inhibit the migration/differentiation of?

Back 5

1. monocytes from blood
2. t cells from blood
3. VSM

Front 6

What are 4 Fx of NO?

Back 6

1. dilation
2. inhibits platelet adhesion (antithrombosis)
3. inhibits leukocytes from attacheing to endo, anti inflammatory
4. inhibits growth/migration of VCM

Front 7

how does NO prevent thrombosis?

Back 7

not letting plateles adhere

Front 8

what is the precursor to NO?
WHat enzyme?
where does NO bind?

Back 8

Arginine
NOS
guanyl cyclase on VCM,

Front 9

what is artherogensis?

Back 9

plaque formation

*response of endo to injury

Front 10

what are the 4 general phases of plaque formation (artherogenesis)

Back 10

1. Endo damage, this alerts monocytes to become macrophages and LDL oxidation in sub endo

2. Foam Cells: macrophages use scavernger receptor to eat up LDL

3. Fibrous plaque: Fibrous cap from secretions of VCM, Necrotic core, foam cell necrosis

4. Advanced Lesion: plaque rupture, thrombis or Growing plaque leading to stenosis

Front 11

we know that plaque formation begins with endo damage. how is endo damage and what happens when its damaged?

Back 11

smoking
turblance due to branching or HTN
infection

**when injured the endo is permiable and lets LDL in and macrophages. Cytokines are released that recruit more macrophages/monocytes Less NO is made so vessels constrict

Front 12

why dont we want macrophages in the vessels?

Back 12

**remember they ge there when vessels are injured bc of increased permiability and recruitment by cytokines

**they make ROS, and try to eat up the LDL via scavenger receptors. they also make things that turn off NO synthesis

Front 13

so the sedonc step of artherogenesis, fatty streak. how does it happen?

Back 13

1. endo damage
2. FOAM CELL: fatty streak

**macrophages make ROS that oxidize LDL, the oxidLDL is then taken up by macrophages via scavenger receptors (cant stop it). The macrophages cant degrade cholesterol and become foam cells

Front 14

where is foam cell formation common? why?

Back 14

branch points

**high turbulence, this leads to endo damage, this leads to increased LDL and macrophages entering BV walls

**also HTN will increase turbulence and increase foam cell formation

Front 15

how do levels of LDL and HDL affect foam cell formation

Back 15

LDL, increased foam cell
HDL, decreased foam cell

Front 16

what layer does foam cell formation occur?

Back 16

intima

Front 17

what is the necrotic core of a plaque

Back 17

dying foam cells,

covered by fibrous cap in step 3 of artherogensis

Front 18

how is the fibrous cap (step 3) formed?
who secretes what where and what happens

Back 18

1. endo damage
2. foam cell
3. Fibrous Cap: macrophages/endo make cytokines that tell SM to enter the intima where the action is occuring

**VCM in the intima secrete EMC which is the cap, the cap is hardened with Ca

Front 19

what happens when the firbours cap of a plaque is unstable

Back 19

it can rupture, thrombosis

Front 20

what are demographic features that increase ones risk of CVD that CANT be changed

Back 20

man
over 40
family Hx

Front 21

what are lipid risk factors for increased risk of CVD

Back 21

1 high total cholesterol
2. low HDL

Front 22

what are 5 things that a 45 yo man whos mom died of CVD do to prevent his risk? what cant he change?

Back 22

1. HTN- turbulence increased
2. DM (glycation, endo damage)
3. Smoking- increased damage
4. Obesity- IR and fat metabolism
5. Inactive

**he cant change that hes a man, hes old, and his momma died

Front 23

what does cholesterol need to be under to decrease risk of CVD

Back 23

200 or less

Front 24

why is hi HDL good to lower risk of CVD

Back 24

reverse cholesterol transport

**removes cholesterol from endo/peripheral tissue and brings it to the liver

Front 25

is having high HDL AND LDL as good as HIGH HDL and low LDL

Back 25

better to have high HDL nad low LDL than high both

Front 26

how are SFA related to CVD? what is the mech

Back 26

SFA increase CVD

**SFA increase LDL by decreaseing LDL receptors on liver, this means LDL cant enter the liver so they have to float around and then they get into vessels

Front 27

what do mryistic acid and palmitic acid do to CVD

Back 27

these are SFA, they block the bililiy of LDL to get in the liver, LDL circulates and stays in the blood ---> increased CVD

Front 28

where are lots of mryistic and palmitic acid found

Back 28

SFA
whole milk, cheese
solid animal fat (red meat)

**less than 7% of calories shoudl be from SFA, typically its 11%

Front 29

what happens when LDL receptor activity is increased? decreased? give an example that increases or decreases activity

Back 29

Increased: less LDL in circulation and less risk for CVD, increases LDL receptor with increased MUFA, PUFA (lineolic acid, omega 6)

Decreased: less LDL enters liver and so it floats around and increases CVD, SFA do this

Front 30

what are MUFA? where are they

Back 30

monounsat FA

**decrease LDL :)


olive oil
almond oil
canola oil
high oleic safflower oil

Front 31

what are trans FA? are they good or bad, where are they found?

Back 31

TFA, MUFA that looks liek a SFA

BAD!!! increase LDL, decrease HDL

Found in processed food, not in plants or animals

Front 32

what are PUFA's? where are they found

Back 32

polyunsat FA

omega 3,6
lineolic acid

increase LDL receptor activity to decrease LDL in circulation

**seed oils, walnuts

Front 33

does omega 3 or 6 affect cholesterol levels

Back 33

6

*increases LDL receptor activity to decrease LDL in circulation

Front 34

what kind of fat is lineolic acid, what does it do?

Back 34

PUFA

decrease LDL

Front 35

where do ya find omega 3? what does it do to CVD, how?

Back 35

fish (EPA, DHA)

Salmon
Mackerl
Anchovies
Sardines
Herring

**great reduction in CVD risk, but doesnt alter cholesterol levels. THey decrease platelet aggregation

**omega 3 are weak platelet aggregators, no aggregation, no thrombosis!

Front 36

if you cut off the fat of a steak are you lowering the amt of cholesterol your eating? will you lower any fat consumption?

Back 36

not really, lots of cholesterol in the lean meat

you cut off the SFA

Front 37

is ALL cholesterol abs in mixed micelles?

Back 37

nope, only 50% abd with micelles

Front 38

whats a more influential role on LDL cholesterol levels
1. dietary cholesterol intake
2. composition/amt of fats eaten

Back 38

2. the AMT of TYPE of fat is way more important in determining LDL levels

Front 39

how are HDL/LDL affected by...
1. TFA
2. SFA
3. MUFA
4. PUFA 6
5. PUFA 3

Back 39

1. TFA- LDL hi, HDL lo
2. SFA: LDL hi, HDL ---
3. MUFA: LDL low, HDL lo
4. PUFA 6: LDL lo, HDL lo
5. PUFA 3: HDL ---, HDL --

Front 40

Nuts do what to cholesterol, what kind of fats do they have

Back 40

decrease cholesterol

MUFA, PUFA

**they are exceptionally good, good beyond pure replacement of fats

Front 41

do all high fat diets result in CVD?

remember the three nations and their food?

Back 41

NO!

only diets high in SFA

Japenese: low total fat but lots of SFA, high CVD
North European: HIGH fat dies, high SFA, high CVD
Medeterranian: HIGH fat diet but LOW SFA, low CVD

**quality over quantity

Front 42

what are sterols/stanols, how do they affect cholesterol levels

Back 42

lower LDL
nothing with HDL

**found in plants, similiar structure to cholest

Front 43

how do sterols work to lower LDL

Back 43

they are incorporated into mixed micelles so cholesterol cant be incorporated

Front 44

what does fiber do to cholesterol? how?

Back 44

decrease cholesterol

their digestion interferes with bile salt reabsorption (they are pooped out!) so more cholesterol is used to make bile salts and so is taken out of circulation

Front 45

what does eating oatmeal, fruit, veggies, legumes do to cholesterol

Back 45

FIBER!!!

it reduced cholesterol by interfering with bile salt abs. bile salts (and the cholesterol in them) are pooped out and cholesterol is taken from circulation and used to make bile salts

Front 46

what happens to cholesterol when you loose weight

Back 46

decreases

Front 47

how is HDL increased

Back 47

exercise

Front 48

what does booze do to cholesterol

Back 48

increases HDL

Front 49

what are the 7 things that the ntnl cholest education program recommends?

Back 49

1. eat lean meats and plants
2. dont eat visible fat, milk products
3. eat carbs: complex from grain/veggies/fruit
4. fish 2x/week
5. replace SFA with MUFA/PUFA
6. Loose weight
7. exercise

Front 50

what are the reccomendations

SFA
PUFA
MUFA
Cholesterol
Total Fat

Back 50

SFA <7% total cal
PUFA 10% total cal
MUFA 20% total cal
Cholest <200mg/day
Total Fat 20-35% total cal, remember its what KIND of fat, not how much!

Front 51

do all ppl with MI have high cholest

Back 51

nope, 50% dont

Front 52

if you.... you are 95% liekly to have CVD

Back 52

1. smoke
2. DM
3. HTN
4. Hypercholesterolemia