Vascular Biology

Front 1

Describe the tunica intima?

Back 1

single layer of endothelial cells, serves as metabolic and communicatory barrier between blood and vessel

Front 2

Main functions of vasc endothelium?

Back 2

inhibit thrombosis/inflammation, Maintain Vascular Tone, Regulate smooth muscles

Front 3

What types of circulating factors are procoagulants and which are anti?

Back 3

Pro - tissue factor; Anti - thrombomodulin, Protein S, Protein C

Front 4

What type of vascular changes happen in atherosclerotic sgements of vasc?

Back 4

neovascularization

Front 5

What is the general process of atherosclerotic plaque dev?

Back 5

endothelial damaged by trauma, LDL accumulates in intima, LDL modified, Dysfunctional damaged endo secretes chemokines, expresses integrins, Macros show up, Modified LDL accumulates in Macros, Macros secrete more cytokines, SM cells relocate to intima,

Front 6

What types of processes lead to LDL modification?

Back 6

Oxidation, Glycation

Front 7

What type of LDL particle is worse for atherosclerosis: large or small and dense?

Back 7

small and dense;

Front 8

What type of molecule facilitates monocyte adhesion and entry through epithelium?

Back 8

integrins

Front 9

Diff between selectins and integrins?

Back 9

Selectins mediate loose rolling leukocyes; Integrins, firmer attachment

Front 10

What kinds of things cause endothelial dysfunction?

Back 10

Hyperlipidemia, Smoking, HTN, Diabetes

Front 11

What type of chemokine is the main attractor of Monocytes that is secreted by dysfunctional epi?

Back 11

MCP 1

Front 12

How are the SM cells enticed to migrate and how do they pull it off?

Back 12

follow chemokines secreted by leukos and endos; Secrete elastases to degrade matrix and penetrate through;

Front 13

Hpw can SM migration contribute to plaque rupture?

Back 13

their elastases and metalloproteinases weaken the fibrous cap predisposing to rupture

Front 14

What is responsible for increased predisposition to plaque formation in ruptured plaques?

Back 14

T lymphos and macros secrete increased procoagulant tissue factor

Front 15

What is responsible for intraplaque hermorrhages and what happens because of them?

Back 15

Fragile vasa vasorum; platelets come, stim CD40 ligand, triggers adhesion mols, MMPs and tissue factor

Front 16

Three types of atherosclerotic lesion progression and their outcomes?

Back 16

Compensatory expansive remodeling - asymptomatic; Constrictive remodeling - angina; Excessive expansive remodeling - acute coronary syndrome (because of high rupture risk);

Front 17

What is positive remodeling?

Back 17

outward expansion of arterial wall

Front 18

What types of serologic tests do we run to get an idea of atherosclerotic risk?

Back 18

Lipid studies (total Chol, LDL, HDL, Triglycerides); Inflammatory markers;

Front 19

What does NMR lipoprofile tell you?

Back 19

number and size of HDL, LDL, other chol particles

Front 20

What would be a lipid NRM that might worry you?

Back 20

high numbers of small dense LDL

Front 21

What is the main serologic inflammatory marker used to asses athero risk?

Back 21

C reactive protein

Front 22

What would be the combination of C reactive level and HDL level that would put a person most at risk?

Back 22

Low HDL, high C reactive

Front 23

What is the detection gap?

Back 23

The discrepancy between the number of people that have a disease and the number we catch

Front 24

Relationship between vascular calcification and CAD?

Back 24

Calcification usually present, but doesn't have to be;

Front 25

What types of imaging can be used to detect athero?

Back 25

MRI, Angiogram, IVUS,

Front 26

What is the histopathologic signature of a vulnerable plaque?

Back 26

thin cap, lipid rich core, Low calcium, outward expansion, hemorrhage, less SM cells;

Front 27

Most commonly used form of imaging to look at plaque morphology?

Back 27

IV ultrasound;

Front 28

What is the goal of spectroscopy with regards to atherosclerosis imaging?

Back 28

analyze the plaque by tissue content

Front 29

Which imaging technique is best for detecting plaque calcification?

Back 29

CT

Front 30

What occurs first in atherosclerotic lesion, VV proliferation or Endo dysfunction?

Back 30

VV prolif, earlier by two weeks;

Front 31

How long does it take for Endo dysfunction to occur?

Back 31

4 weeks

Front 32

What is the goal of theranostics?

Back 32

deliver therapy with a diagnostic procedure, check later and see effect

Front 33

What is the goal of ather imaging?

Back 33

Dx patients before they have clinical symptoms

Front 34

Acute coronoary events are more likely to occur from what: gradual stenotic narrowing and plaque rupture?

Back 34

rupture