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130 Cards in this Set
- Front
- Back
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ANATOMY & BASICS
- Arteries have 3 categories based on what 2 features? |
- Size
- Histologic features |
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ANATOMY & BASICS
- What are the 3 categories for arteries? |
- Large Elastic arteries
- Medium Muscular arteries - Small arteries |
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ANATOMY & BASICS
- 3 coats of arteries |
- Tunica intima
- Tunica media - Tunica adventitia |
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ANATOMY & BASICS
- Tunica intima composed of? x2 - Tunica intima outer limit? |
- Endothelial cells + CT
- Internal elastic membrane |
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ANATOMY & BASICS
- Tunica media composed of? x2 - Tunica media outer limit? |
- Elastic fibers + SM
- External elastic membrane |
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ANATOMY & BASICS
- Tunica adventitia composed of? x4 |
(LENS)
- Elastic fibers + CT Layers - Nerve fibers - Small nutrient vessels |
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ANATOMY & BASICS
VEINS - Walls are thick or thin? - Lumen is large or small? - what is found in many veins? x2 |
- Thin walls
- Large lumen - Valves - Endothelial Folds |
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ANATOMY & BASICS
VEINS - Predisposed to what actions? x2 - Predisposed to what pathology? x2 |
- Dilation
- Compression (PIT) Penetration easily by - Tumors - Inflammation |
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ANATOMY & BASICS
- Lymphatics structure describe - Major function is what? |
- Thin-walled, endothelium-lined channels
- Protective drainage system |
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VALVULAR DZ SIGNIFICANCE
- Dz weakening the wall of vessel can lead to what? x2 - Dz narrowing lumen can lead to? - Dz damage to endothelial lining can provoke |
(Weak DR's w/ Narrow-minded ISsues Damage IT)
- Dilation - Rupture - Ischemia - Intravascular Thrombosis |
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ATHEROSCLEROSIS
- characterized by what plaque? - above plaque aka? |
- Atheromas
- Fibrofatty Intimal Plaques |
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ATHEROSCLEROSIS
- Dz of what arteries? x4 |
- Large Muscular
- Large Elastic - Medium Muscular - Medium Elastic |
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ATHEROSCLEROSIS
- describe its progressive nature? - begins/onset when? |
- Slowly progressive
- childhood onset |
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ATHEROSCLEROSIS
- as Dz advances, the atheromas become what? x2 |
- More numerous
- Increase in size |
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ATHEROSCLEROSIS
CLINICAL MANIFESTATION - Atherosclerosis compromises vasculature how? x2 |
- Compromises Arterial blood flow
- Weakens Arteries |
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ATHEROSCLEROSIS
CLINICAL MANIFESTATION - possible Atherosclerosis complications? x5 |
(UCHAT)
- Ulcerations - Calcifications - Hemorrhage - Aneurysmal dilation - Thrombus formation |
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ATHEROSCLEROSIS
CLINICAL MANIFESTATION - clinical manifests of atherosclerosis? x4 |
(G-MAC)
- Gangrene - MI - AAA - Cerebral Infarct |
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ATHEROSCLEROSIS
EPIDEMIOLOGY - Deaths due to CAD & Strokes have increased or decreased over the years? - due to what measures? x4 |
- Decreased
(HDL Therapy) - HTN control is better - Diet changes - Lifestyle changes - Therapy improvement |
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ATHEROSCLEROSIS
EPIDEMIOLOGY - what Dz in the US is still the highest in all the world for Death rate? |
- Ischemic Heart Dz (IHD)
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ATHEROSCLEROSIS
EPIDEMIOLOGY - in terms of Both Pathogenesis and Progression, what choices are of some importance? x3 |
(DLP)
- Diet - Lifestyle - Personal Habits |
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ATHEROSCLEROSIS
EPIDEMIOLOGY - what is the variability of occurrence & severity in atherosclerosis? - what explains some of differences in variability |
- Still variable EVEN among individuals of similar cultures/lifestyles
- Genetics factors explains some of these differences |
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ATHEROSCLEROSIS
RISK FACTORS - list the 7 MAJOR risk factors |
(ASDF CHH)
- Age - Sex - DM - Familial Disposition - Cigarette smoking - HTN - Hyperlipidemia |
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ATHEROSCLEROSIS
RISK FACTORS - list the 9 SOFT risk factors |
(Soft hits ECHOES CFL)
- Exercise insufficiency - Chlamydia pneumoniae - Homocysteine Dz - Obesity - Estrogen Def. (Post-menopaus) - Stress, type A, Competitive life - Carb intake is high - Fat (hard & unstaturated) intake - Lipoprotein A |
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ATHEROSCLEROSIS
RISK FACTORS - explain how sex is a risk factor for males - explain how sex is a risk factor for females |
- Death rates for IHD highest
- @ age 75-85, women catch up to men |
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ATHEROSCLEROSIS
RISK FACTORS - example of how familial disposition / genetic abnormalities is a risk factor |
some families suffer increased frequency
of MI @ earlier age |
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ATHEROSCLEROSIS
RISK FACTORS - DM induces what? - above induction will increase what predisposition? |
- HyperCholesterolemia
- Atherosclerosis |
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ATHEROSCLEROSIS
RISK FACTORS - HTN induces what? - above induction will increase what predisposition? x2 |
- Atherogenesis acceleration
- IHD - CVD (cerebral vascular dz) |
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ATHEROSCLEROSIS
RISK FACTORS - HTN increases BP, but which BP plays a role in increasing the risk? - Anti-Hypertensive therapy reduces the incidence of what? |
- BOTH Systolic & Diastolic
- Strokes (CVA) - IHD |
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ATHEROSCLEROSIS
RISK FACTORS - explain the impact of cigarettes on Atheroscelerosis |
Death rates
from IHD in smokers is 70% to 200% higher |
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ATHEROSCLEROSIS
RISK FACTORS HyperLIPIDEMIA is a risk factor, but how strong is the evidence that HyperCHOLESTEROLEMIA is a major risk factor? |
- Lots of evidence it is a Major Risk factor
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ATHEROSCLEROSIS
HYPERLIPIDEMIA EVIDENCE - Plaques of Atherosclerosis is RICH in what contents? x2 - above contents derived from where? |
- Cholesterol
- Cholesterol Esters - Lipoproteins in blood |
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ATHEROSCLEROSIS
HYPERLIPIDEMIA EVIDENCE - Acquired disorders that cause what condition is considered a risk factor? - These Acquired Disorders increase the risk for? |
- Hypercholesterolemia
- IHD |
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ATHEROSCLEROSIS
HYPERLIPIDEMIA EVIDENCE - Give 2 Acquired Dz's that cause Hypercholesterolemia, thus increasing risk for IHD. |
(Hy-Ne)
- Nephrotic Syndrome - HYPO-Thyroidism |
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ATHEROSCLEROSIS
HYPERLIPIDEMIA EVIDENCE - Genetic disorders that cause severe Hypercholesterolemia lead to what pathology? - what is the prognosis? - what is the prognosis if there are no other risk factors involved |
- Premature atherosclerosis
- often Fatal in childhood (despite the absence of any other risk factors) |
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ATHEROSCLEROSIS
HYPERLIPIDEMIA EVIDENCE - Experimental animals can be induced into Atherosclerosis by? |
- Feeding them diets that raise plasma Cholesterol
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ATHEROSCLEROSIS
HYPERLIPIDEMIA EVIDENCE - Populations having higher levels of blood cholesterol have what correlation? |
- Higher MORTALITY of IHD
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ATHEROSCLEROSIS
HYPERLIPIDEMIA EVIDENCE - Correlation in Plasma levels showing evidence of Hyperlipidemia as a risk factor |
- Higher Plasma Cholesterol Level
the Higher the Risk |
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ATHEROSCLEROSIS
HYPERLIPIDEMIA EVIDENCE - Correlation of what Plasma Cholesterol Levels identifies individuals at risk? |
- there is no single level.
(just higher the level, higher the risk) |
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ATHEROSCLEROSIS
HYPERLIPIDEMIA EVIDENCE - describe the evidence with HDL |
- serum HDL levels are INVERSELY proportional to atherosclerosis risk
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ATHEROSCLEROSIS
HYPERLIPIDEMIA EVIDENCE - describe the evidence with LDL - is this evidence strong? - why or why not? |
- elevated LDL has a striking association with atherosclerosis
- Most striking association - LDL by definition is the lipoprotein moiety RICHEST in Cholesterol |
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ATHEROSCLEROSIS
HYPERLIPIDEMIA EVIDENCE - describe the evidence with VLDL |
- Hypertriglycerides with increased [VLDL] appears to increase the risk of atherosclerosis
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ATHEROSCLEROSIS
HYPERLIPIDEMIA EVIDENCE - List all the evidence in support of Hyperlipidemia / hypercholesterolemia as a major risk factor. x9 |
(PAGE PC - HLV)
- Plaques rich in Chol. & Chol. E. - Acquired Dz (Hy,Ne) incr. IHD risk - Genetic Dz --> Premature Athero. - Expt'al animals: Diet --> Athero - Populations w/ high Chol. --> high IHD Mortality !!!! - Correlation: higher Chol. & higher risk - HDL is inversely proportional to risk - LDL: richest in Chol. Most striking - VLDL: hyperTRIglycerides w/ high VLDL incr. risk |
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ATHEROSCLEROSIS
RISK FACTOR - each MAJOR risk factor contributes how to the development of Atherosclerosis - Multpile factors affect how? |
- contributes INDIVIDUALLY
- MORE than an Additive Effect |
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ATHEROSCLEROSIS
RISK FACTOR - SOFT risk factors increase the risk of atherosclerosis, but... x2 |
- LESS pronounced
- DOCUMENTATION is difficult in statistical terms |
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ATHEROSCLEROSIS
RISK FACTOR - what microorganism is considered a risk factor? - is the risk factor a Major or Soft risk factor? |
- Chlamydia pneumoniae
- Soft risk factor |
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ATHEROSCLEROSIS
LIPID METABOLISM - Lipoprotein core component - Lipoprotein core is surrounded by? x2 |
- Neutral lipid
- Polar lipid - Apoprotein |
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ATHEROSCLEROSIS
LIPID METABOLISM - Lipoprotein function to transport what? - from? - to? |
- Triglyceride transport
- sites of origin - sites of Energy Storage |
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ATHEROSCLEROSIS
LIPID METABOLISM - Plasma Lipoprotein are divided into how many Types? - these division are based on? x2 |
- 5 types (C H I L V)
- Electrophoretic mobility - Sedimentation properties |
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ATHEROSCLEROSIS
LIPID METABOLISM - List the 5 types of Plasma Lipoproteins |
- Chylomicrons
- HDL - IDL - LDL - VLDL |
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ATHEROSCLEROSIS
LIPID METABOLISM - which lipoprotein has the lowest density? |
- chylomicrons
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ATHEROSCLEROSIS
LIPID METABOLISM - which lipoprotein mainly transports Triglycerides SYNTHESIZED by the LIVER? |
( li-V-er)
(Vldl Loves Da Liver triglycerides) - VLDL |
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ATHEROSCLEROSIS
LIPID METABOLISM - what is IDL (intermediate density lipoprotein)? |
- Remnants generated from action of Lipoprotein Lipase on VLDL
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ATHEROSCLEROSIS
LIPID METABOLISM - which lipoprotein functions primarily to transport ENDOGENOUS cholesterol to body cells? x2 |
- HDL
- LDL |
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ATHEROSCLEROSIS
LIPID METABOLISM - Lipoprotein Lipase action is done on what lipoprotein? - what change occurs to that lipoprotein? |
- VLDL
- converts it to a remnant molecule called IDL |
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ATHEROSCLEROSIS
LIPID METABOLISM - VLDL transports what type of compound? |
- Triglycerides
synthesized by LIVER |
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ATHEROSCLEROSIS
LIPID METABOLISM - which lipoprotein contains the majority of total cholesterol levels in plasma for average American? - what is that majority %? |
- LDL
- 70% |
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ATHEROSCLEROSIS
LIPID METABOLISM - which lipoprotein is ONLY found in plasma after a MEAL |
(just like Chyme)
- Chylomicrons |
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ATHEROSCLEROSIS
LIPID METABOLISM - which "good" lipoprotein is inversely associated with atherosclerosis risk? |
- HDL
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ATHEROSCLEROSIS
LIPID METABOLISM - which lipoprotein is the most strongly correlated with Atherosclerosis? |
- LDL
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ATHEROSCLEROSIS
LIPID METABOLISM - Lipoprotein A plasma levels are correlated with an increased risk of what? x2 |
- CAD (Coronary Artery Dz)
- CVD (CerebroVascular Dz) |
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ATHEROSCLEROSIS
LIPID METABOLISM - Lipoprotein A is an altered form of what? |
- LDL
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ATHEROSCLEROSIS
LIPID METABOLISM - Lipoprotein A has what 4 Atherogenic effects? |
(LpA can be seen with a LENS)
- Lipid accumulation - Endothelial Cell modulation - Neovascularization control of Plaques - Smooth muscle cell proliferation |
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ATHEROSCLEROSIS
LIPID METABOLISM - what are Apoproteins? |
- Protein constituents of Lipoproteins
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ATHEROSCLEROSIS
LIPID METABOLISM - Apoprotein functions x3 |
(Apop-LET-eal)
- Ligand for cell receptors - Enzyme activation/inhibition - Transmembrane Transport facilitation |
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CHOLESTEROL
TRANSPORT PATHWAYS - what are the 2 transport pathways for cholesterol |
- Endogenous
- Exogenous |
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS - which Lipoprotein is Supa impotent in the ENDO pathway? |
- Chylomicrons
(seen post meal) |
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS - Chlyomicrons transport what type of cholesterol? x2 - transport to where? x2 |
- EXOgenous Cholesterol to Liver
- Triglycerides to Muscle/Adipose tissue |
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS - what is put in to Chylomicrons? x2 - where does this happen? |
- Dietary Triglycerides
- Dietary Cholesterol - Intestinal Epithelial Cells |
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS - From the Intestinal Epithelial cells, Chylomicrons will go where? - how do they get there? |
- Peripheral Capillaries
- Intenstinal Lymphatics |
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS - what enzyme acts on Chylomicrons? - this action does what? |
- Endothelial Lipoprotein Lipase
- Liberates FATTY Acid into (MAT) Muscles and Adipose Tissue |
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS - after enzymatic action, the Chylomicron remnants, are rich in what? - Chylomicron remnants make their final destination to what location? - once there, they are taken up by what process? |
- Cholesterol rich
- Liver - Receptor mediated PINOcytosis |
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS - Chylomicrons are degraded by? |
- Liver Lysosomes
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS - what is the initial lipoprotein involved in the EXOgenous pathway? - made and secreted by? - transported to where? x2 |
- VLDL
- Liver - (MAT) Muscle & Adipose Tissue |
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS - once VLDL reaches the (MAT) Muscle and Adipose Tissue, what happens to VLDL? |
- changes to LDL
(via IDL) |
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS - LDL is metabolized via what 2 pathways? - give %'s |
- LDL receptor pathway - (2/3)
- LDL receptor-independent pathway (1/3) |
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS - in the LDL-Receptor pathway, what cells metabolize the LDL? |
- Liver cells
(& some others) - Scavenger cells of Mononuclear Phagocyte System (& endocytosis in some other cells) |
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS - HDL is part of what pathway? - HDL transports what? |
- Endogenous pathway
(just like all the non-chylomicrons) - UN-Esterified cholesterol |
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS - Unesterified cholesterol is derived from where? - Unesterified cholesterol is transported by? |
- Normal Turnover of Cell membranes
- HDL |
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS - Unesterified cholesterol found in HDL is transported to what lipoprotein? - via what enzyme? |
- IDL
- LCAT (lecithin cholesterol acyl transferase) |
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS UNESTERIFIED CHOLESTEROL - initially derived from? - initially transported by? - then transported into? - then transported into? |
- normal turnover of cell membrane
- HDL - IDL - LDL |
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ATHEROSCLEROSIS
TRANSPORT PATHWAYS - what is the function of LCAT? |
- help transfer the Unesterified cholesterol from HDL to IDL (to LDL?)
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GENETIC & ACQUIRED
DERANGEMENTS - Genetic & Acquired derangements influence what? x2 |
- Exogenous cholesterol pathway
- Endogenous cholesterol pathway |
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GENETIC & ACQUIRED
DERANGEMENTS - Genetic & Acquired derangements that influence the ENDO & EXO cholesterol pathways are associated with what condition? |
- Dyslipoproteinemias
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GENETIC & ACQUIRED
DERANGEMENTS - Dyslipoproteinemias can be manifest primarily as? - secondarily as? |
- Genetic defect of Lipid metabolism
- Secondary to some Underlying disorder |
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GENETIC & ACQUIRED
DERANGEMENTS - List 3 genetic defects in lipid metabolism that causes Dyslipoproteinemias. |
(ALF is genetically deranged)
- Apoprotein defects - Lipoprotein A Dz - Familial Hypercholesterolemia |
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GENETIC & ACQUIRED
DERANGEMENTS - Genetic defects in Apoprotein associated with? x2 |
- Dyslipoproteinemia
- Accelerated Atherosclerosis |
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GENETIC & ACQUIRED
DERANGEMENTS FAMILIAL HYPERCHOLESTEROLEMIA - caused by? - inheritance pattern? |
- Defect in the LDL receptor
- AD |
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GENETIC & ACQUIRED
DERANGEMENTS - patients with homozygous familial hypercholesterolemia exhibit Dz how? x2 |
- Early onset IHD
- Malignant course of IHD |
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GENETIC & ACQUIRED
DERANGEMENTS - High levels of LpA is associated with a high risk of? - LpA is what kind of particle? |
- Atherosclerosis Dz
- Altered form of LDL |
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GENETIC & ACQUIRED
DERANGEMENTS - Dyslipoproteinemias can be secondary to what other conditions? x7 |
(2nd to none is NOH's Pregnancy RAP)
- Nephrotic syndrome - Obstructive Biliary Dz - HYPO-Thyroidism - Pregnancy - Renal Dz - Alcohol - Pancreatitis |
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ATHEROSCLEROTIC MORPHOLOGY
- AHA classification divides atherosclerotic lesions into how many types? |
6 types
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ATHEROSCLEROTIC MORPHOLOGY
- list the types of lesion in atherosclerosis. |
(FIA)
- Fatty streak - Intimal Cell Mass - Arthromatous plaque (arthromas) |
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ATHEROSCLEROTIC MORPHOLOGY
Color for the following: - Fatty streak - Intimal cell mass - Arthromas |
- Yellow
- White - Yellow to white |
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ATHEROSCLEROTIC MORPHOLOGY
Size for the following: - Fatty streak - Intimal cell mass - Arthromas |
- Width less than 1 to 2 mm
(length can be > 1 cm) - unk - Varies from 0.3 cm to 1.5 cm |
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ATHEROSCLEROTIC MORPHOLOGY
NOT associated for the following: - Fatty streak - Intimal cell mass - Arthromas |
- Blood Flow is NOT disturbed
- Lipid is NOT found in histo - N/A |
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ATHEROSCLEROTIC MORPHOLOGY
- Histo for Fatty streak x5 |
(Fatty FISTY)
- Flat, multiple spots - Intracytoplasmic Lipid droplets - Smooth muscle cell ELONGATION - T-lymphocyte - Yellowish |
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ATHEROSCLEROTIC MORPHOLOGY
- Histo for Intimal Cell Mass x4 |
(I C Massive CAWS)
- CT - Arterial branch location - White - Smooth muscle cells (Remember: NO lipids seen) |
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ATHEROSCLEROTIC MORPHOLOGY
- Histo for Artheromas x3 |
(Arthur's Lie to CC)
- Lipid deposits Intra- & Extracellularly - CT (w/ (PEC) PG, Elastin, Collagen) - Cells of different types (MSW - Macro-, SM cells, WBCs) |
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ATHEROSCLEROTIC MORPHOLOGY
- Histo for Artheromas have lipid deposits where? |
- Intracellularly & Extracellularly
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ATHEROSCLEROTIC MORPHOLOGY
- Histo for Artheromoas have CT including what 3 things? |
(PEC)
- Proteoglycans (PG) - Elastin - Collagen |
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ATHEROSCLEROTIC MORPHOLOGY
- Histo for Artheromas have what type of cells associated? x3 |
(MSW)
- Macrophages - Smooth muscle cells - WBC's |
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ATHEROSCLEROTIC MORPHOLOGY
Describe the locations for: - Fatty streaks - Intimal cell mass - Arthromas |
- AORTA of children older than 1 y.o.
(regardless of geography, race, sex, environment...) - BRANCH points of Arterial tree ("cushions") - CONSTANT distribution (CC PAID) |
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ATHEROSCLEROTIC MORPHOLOGY
- what is the relationship of Fatty Streaks to Atherosclerotic plaques? - Later progressed Atherosclerotic plaques correlate well with the location of what? |
- May be Precursor, but is currently Controversial
- Intimal cell mass |
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ATHEROSCLEROTIC MORPHOLOGY
- What is a "cushion" |
- Common location of Intimal cell mass
- which is at Arterial Branch points |
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ATHEROSCLEROTIC MORPHOLOGY
- Common locations for Atherosclerotic plaques is Variable or Constant? - list the common areas? x6 |
Constant
(Constant Location of pitches is why CC PAID!) - Coronary arteries (w/ in first 6 cm) - Circle of Willis - Popliteal artery - Abdominal Aorta (esp. @ ostia) - Internal Carotid Artery - Descending Thoracic Artery |
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ATHEROSCLEROTIC MORPHOLOGY
- Gross observation of the Atherosclerotic plaques show what character? x3 |
(PEV)
- Patchy - Eccentric - Variable |
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ATHEROSCLEROTIC MORPHOLOGY
- which plaque protrudes into lumen? |
Arthromas
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ATHEROSCLEROTIC MORPHOLOGY
- which plaque involve T-lymphocytes? |
Fatty streak
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ATHEROSCLEROTIC MORPHOLOGY
- which plaques have Smooth muscle cells that are Elongated? |
Fatty streak
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ATHEROSCLEROTIC MORPHOLOGY
- which plaque has NO lipids associated? |
Intimal Cell mass
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ATHEROSCLEROTIC MORPHOLOGY
- which plaques cause the greatest clinical effect? |
Complicated Atherosclerotic plaques
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ATHEROSCLEROTIC
COMPLICATED PLAQUES - Complicated Atherosclerotic plaques occur when there is a series of what? - list them. x5 |
- occurs with series of CHANGES
(U-CHAT complicated plaque & complication of atherosclerosis) - Ulceration - Calcification - Hemorrhage - Aneurysmal dilation - Thrombosis |
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ATHEROSCLEROTIC
COMPLICATED PLAQUES - Complicated Atherosclerotic plaques cause the greatest clinical effect especially if? |
- superimposed thrombosis
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ATHEROSCLEROSIS
PATHOGENESIS - Atherosclerotic lesions develop in what layer of tissue? - of what arteries? x2 |
- Tunica INTIMA
- Muscular arteries - Elastic arteries |
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ATHEROSCLEROSIS
PATHOGENESIS - list the theories for atherosclerosis pathogenesis x7 |
(I RIM HER)
- Insudation hypothesis - RXN to Injury hypothesis - ICM hypothesis - Monoclonal hypothesis - Hemodynamic hypothesis - Encrustation hypothesis - RESPONSE to Injury hypothesis |
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ATHEROSCLEROSIS
PATHOGENESIS - Describe the Insudation Hypothesis |
Lipids inside Lesion is from plasma Lipoproteins
- controversy still as to how lipid enters the wall |
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ATHEROSCLEROSIS
PATHOGENESIS - Describe the RXN to Injury Hypothesis |
Smooth Muscle accumulates due to release of PDGF by platelets and monocytes
- PDGF is a mitogenic & chemotactic factor |
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ATHEROSCLEROSIS
PATHOGENESIS - Describe the ICM Hypothesis |
ICM (REP) is the Precursor, Early lesion, or Reason for SM proliferation in lesions
ICM found in - infancy - correlates well w/ arthroma sites - males are markedly higher for it |
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ATHEROSCLEROSIS
PATHOGENESIS - Describe the Monoclonal Hypothesis |
Alteration of Growth Control by some unknown etiology, possibly mutagen or virus, induces plaques
- plaques are monoclonal for one of very few SM cells. |
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ATHEROSCLEROSIS
PATHOGENESIS - Describe the Hemodynamic Hypothesis |
Endothelial Cell Activities are altered by Hemodynamic factors, and exacerbated by HTN.
- location of atherosclerotic lesions are distributed well in to large vessels for the most part. |
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ATHEROSCLEROSIS
PATHOGENESIS - Describe the Encrustation Hypothesis |
Small Mural Thrombi is the initial event
- formation of expansion of lesion is repetitive process of TO (Thrombosis & Organization) - Expts prove mural thrombus is NOT initial cause, but mural thrombosis is still critical part of lesion progression |
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ATHEROSCLEROSIS
PATHOGENESIS - Describe the Response to Injury Hypothesis |
Chronic Inflammatory Response to Endothelial is what Atherosclerosis is. Caused by the chronic inflammatory response to arterial wall by some injury event leads to atherosclerosis
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ATHEROSCLEROSIS
PATHOGENESIS - Response to Injury Hypothesis involves Chronic Endothelial damage as the etiology. List the sequential events. |
Chronic Endo damage leads to:
(ELM PSL) - Endo dysf(x) --> permeability change & Leuko-adhesion - Lipoprotein insudation and modification by oxidation - Monocyte adhesion leads to --> Intima migration --> Transformation to Foam cells & Macrophages - Plt adhesion & release of PDGF --> activates Endo, Mono-, Plt --> causes SM migration to intima - SM proliferation --> accumulates PG & Collagen - Lipid Accumulation increases |
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VIRUSES & ATHEROSCLEROSIS
- Studies have implicated viral infection as a? - Viral infection is compatible with the importance of what? |
- Possible Pathogenesis Factor
- Cell Proliferation in Plaque Formation |
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ATHEROSCLEROSIS
CLINICAL SIGNIFICANCE - list associated clinical pathologies |
(TIA IT)
- Thombosis - Ischemic Atrophy - Aneurysmal formation/rupture - Infarct - Thromboembolism |
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ATHEROSCLEROSIS
CLINICAL SIGNIFICANCE - what might cause Ischemic Atrophy via atherosclerosis? |
- Narrowing of vessel lumen
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ATHEROSCLEROSIS
CLINICAL SIGNIFICANCE - what atherosclerotic events would cause Infarction? |
(In-far away action --> SOS-TH)
Sudden Occlusion & Superimposed Thrombosis or Hemorrhage |
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ATHEROSCLEROSIS
CLINICAL SIGNIFICANCE -what atherosclerotic events would cause aneurysmal formation or rupture? |
- Weakening of vessel walls
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ATHEROSCLEROSIS
CLINICAL SIGNIFICANCE - Symptomatic Atherosclerosis is often LOCALIZED to the? x5 |
(BK loves LeSi)
- Brain - Kidney - Heart - Lower Extremity - Small Intestines |
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ATHEROSCLEROSIS
CLINICAL SIGNIFICANCE - how might Thrombosis or Thromboembolism occur in atherosclerosis? |
- Damage to Endothelial lining
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