Term
| what is the number one complication of athlerosclerosis, why is this so important |
|
Definition
cardiovascular disease
it is the number one killer in the world |
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|
Term
| where does athlerosclerosis like to form, give 4 examples |
|
Definition
large and medium arteries
aorta, coronary, popliteal, cerebral |
|
|
Term
| what are the two major complications of athlerosclerosis |
|
Definition
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|
Term
| what are 10 risk factors for athlerosclerosis |
|
Definition
age 40+
male (estrogen protects)
FH- hyperlipidemia, cholesteromeia
smoking
hyperlipidemia - diet
hypertension causing vessel stress
diabetes increases lipids in blood
no exercise
obesity
stress |
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|
Term
| what is the major indicator for athlerosclerosis under 40 |
|
Definition
| hyperlipidemia - poor diet |
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|
Term
| why does hyperlipidemia/ hypercholestolemia increase athlerosclerosis |
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Definition
| plaque contains cholesterol so increases in the blood increase chance of plaque formation |
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|
Term
| what are 4 causes of hyperlipidemia/ hypercholesterolemia |
|
Definition
diabetes
myededma
nephrotic syndrome
familial |
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|
Term
| what is the treatment of hyperlipidemia/ hypercholesterolemia |
|
Definition
diet and exercise
cholesterol decreasing drugs |
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Term
| other than a general increase in cholesterol for plaque formation, why is hyperlipidemia one of the MAJOR causes for athlerosclerosis |
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Definition
| it can cause athlerosclerosis all alone. it dosent need other factors to help |
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Term
| what type of dietary fat increases cholesterol and athlerosclerosis risk |
|
Definition
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|
Term
| what type of dietary fat decreases/dosent change cholesterol and decreases/dosent change athlerosclerosis risk |
|
Definition
omega 3 FA
polyunsaturated fats |
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|
Term
| what is the function of LDL, what is its impact on athlerosclerosis |
|
Definition
delivers cholesterol to tissues
increases athlerosclerosis risk |
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|
Term
| what is the function of HDL, what is its impact on athlerosclerosis |
|
Definition
transports cholesterol to the liver for bile excretion
decreases athlerosclerosis risk when >60mg/dL |
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|
Term
| in what 5 ways does smoking increase risk for athlerosclerosis |
|
Definition
decreases HDL
increases CO which causes COHb which causes hypoxia which increases risk
increases platelet adhesion
inncreases permeability of endothelium
nicotine increases sympathetic nervous system |
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|
Term
| what is the most midifable risk factor for athlerosclerosis |
|
Definition
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|
Term
| what happens if hypertension goes untreated |
|
Definition
| 50% die of ischemic heart disease and CHF |
|
|
Term
| what is a sign of long term hypertension |
|
Definition
|
|
Term
| why does diabetes cause hypertension |
|
Definition
increases platelet aggregation
increases LDL
decreases HDL |
|
|
Term
| where does homocystine comes from |
|
Definition
|
|
Term
| how does homocystine cause athlerosclerosis |
|
Definition
inhibits anti-coagulants
causes epithelial damage |
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|
Term
| where is CRP made, by what stimulation |
|
Definition
intima of athelosclerosis
released by inflammation |
|
|
Term
| what levels of CRP are a concern |
|
Definition
|
|
Term
|
Definition
| MI, stroke, peripherial artery disease, sudden cardiac death (even in healthy people) |
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|
Term
| how does CRP cause athlerosclerosis |
|
Definition
released from plaque
causes adhesion and thrombus |
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|
Term
| why do we know CRP has to do with athlerosclerosis |
|
Definition
| it decreases with less smoking, exercise, and statins |
|
|
Term
| what three microbes cause athlerosclerosis |
|
Definition
chalmydia pneumonia
herpes
CMV |
|
|
Term
| how do microbes cause athlerosclerosis |
|
Definition
| initiate inflammatory response |
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|
Term
| what are the three layers of an athlerosclerosis |
|
Definition
intima: fibrous cap then necrotic center
media |
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|
Term
| what is in the fibrous cap of a athlerosclerosis |
|
Definition
smooth muscle
macrophages
foam cells
WBC
collagen
elastin
neurovascularization |
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|
Term
| what is in the necrotic center of an athlerosclerosis |
|
Definition
cell debris
cholesterol
foam cells
calcium |
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|
Term
| what are three stages of athlerosclerosis , which cause disease |
|
Definition
1. fatty streak
2. fibrous plaque - disease
3. complex lesion - disease |
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|
Term
| what are the three stages in the formation of a fatty streak |
|
Definition
initial lesion
fatty streak
intermediate lesion |
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|
Term
| what occurs in an initial lesion |
|
Definition
| some macrophages and foam cells gather |
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|
Term
| what occurs in a fatty streak |
|
Definition
lipid addition intracellulary in intima
increase in macrophages and foam cells |
|
|
Term
|
Definition
| smooth muscle filled with lipid |
|
|
Term
| what occurs in a initial lesion |
|
Definition
increased intracellular lipid and addition of extracellular lipid
stays here for 20 years and digresses or pauses |
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|
Term
| what are the two stages of fibrous plaque formation |
|
Definition
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|
Term
| what occurs in an atheroma |
|
Definition
increased intracellular lipids
formation of core of extracellular lipids |
|
|
Term
| what occurs in a fibro atheroma |
|
Definition
many extracellular lipid cores corm
fibrotic, Ca, collagen, SM covering accumulation |
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|
Term
| what are the complications of a complex lesion |
|
Definition
surface defect: ulcer
hematoma
hemoorrhage
thrombus
scar tissue formation
occlusion |
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|
Term
| what are the 10 complications of athlerosclerosis |
|
Definition
hemorrhage
ulceration
scar tissue
narrowing
ischemia
thrombosis
emboli
weakening of lg arteries (aorta)
coronary artery disease
peripherial artery disease |
|
|
Term
| what starts the athlerosclerosis process |
|
Definition
endothelial unjiry
smooth muscle migration and proliferation
macrophages eating lipids |
|
|
Term
| what causes endothelial injury |
|
Definition
smoking
immune system
mechanical stress: hypertension |
|
|
Term
| what type of disease is athlerosclerosis classified as |
|
Definition
| VISCOUS INFLAMMATORY PROCESS |
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|
Term
| why does athlerosclerosis cause hemorrhage |
|
Definition
|
|
Term
| what does athlerosclerosis cause thrombosis |
|
Definition
|
|
Term
| what vessels does athlerosclerosis usually infarct |
|
Definition
heart
extremities
kidney
SI
brain |
|
|
Term
| what is the normal outcome of athlerosclerosis in a medium size vessel |
|
Definition
| ischemia, infarct, occlusion |
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|
Term
| what is the normal outcome of athlerosclerosis in a large vessel |
|
Definition
|
|
Term
|
Definition
LDL recepors in liver
scavenger receptors on macrophages and monocytes |
|
|
Term
| what stimulates for macro and mono to eat LDL |
|
Definition
| damaged (oxidixation or modification)of LDL |
|
|
Term
| what happens when lots of LDL is dammaged and macrophages and monocytes keep eating it |
|
Definition
| cholesterol ester formation inside them makes them a foam cell |
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|
Term
| plaque formation at the fatty streak level beins with monocyte attachment, then what do they do to cause propogation |
|
Definition
migrate to subendothelium
mature to macrophages
release ROS...
ROS oxidizes LDL so it cannot be taken into liver
macrophages eat LDL making more foam cells
LDL/ROS cause endothelial damage which causes platelet adhesion which releases growth factors which increases collagen, elastin, and proteoglycens
endotheliam damage causes endothelium derived releasing factor inhibition and LDL antibody production which causes vasospasm
lymphocyte and monocyte chemotaxis due to damage |
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|
Term
| what determines if there will be ulceration of a plaque |
|
Definition
| strength and Ca content of outer layer stimulated by GF release from adhering platelets |
|
|
Term
| why do lymphocytes and monocytes come to plaque |
|
Definition
|
|
Term
| why does the immune system make antibodies to the plaque |
|
Definition
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|
Term
| why is there vasospasm around a plaque |
|
Definition
anti-LDL antibodies
decrease in endothelium derived releasing factor
due to endothelial damage |
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|
Term
| define coronary artery disease |
|
Definition
| cardiac disease caused by impaired coronary flow |
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|
Term
| what are 5 causes of coronary artery disease, which is the most common |
|
Definition
1. athlerosclerosis
MI
dysarrhythmia
cardiac failure
suddent cardiac death |
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|
Term
| what is the most common cause of Mi, why |
|
Definition
| athlerosclerotic plaque deposits |
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|
Term
| what is the cut off point for coronary a disease diagnosis, why |
|
Definition
| at 75% occlusion vasodilation cannot compensate anymore |
|
|
Term
| what are the two types of coronary artery disease and their mechanism |
|
Definition
stable/fixed lesion: chronic disease. silent MI, etc
unstable/vulnerable lesion: can rupture (plaque dysruption) causing platelet adhesion and thrombosis |
|
|
Term
| what is the tx for coronary a disease |
|
Definition
| antiplatlet drugs avoid formation of blockage after rupture avoiding thrombosis (asprin) |
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|
Term
| define peripherial artery disease |
|
Definition
| obstruction of large arteries not within coronary, aorta, or brain |
|
|
Term
| what are causes of peripherial artery disease |
|
Definition
athlerosclerosis blockage
inflammation
embolism
thrombus |
|
|
Term
| what is the mechanism causing problems in peripherial artery disease |
|
Definition
| acute or chronic ischemia |
|
|
Term
| what are the risk factors for PAD |
|
Definition
|
|
Term
|
Definition
pain
weakness
numbness
cramping
sores
wounds
ulcers
slow healing
bluness, paleness
coolness
less hair and nail growth |
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