8165433
Description
Flashcards by Shannon Austen, updated more than 1 year ago
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Created by Shannon Austen
about 7 years ago
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| Question | Answer |
| List the circulating lipids associated with atherosclerosis from worst fats to best fats | Chylomicron, VLDL, IDL, LDL, HDL |
| Describe circulating lipids | They are made up of varying amounts of lipid and protein, the more protein the more likely they are taken up by the body (good). The more lipid the more likely they will float around in the blood and become atheroma |
| which cells are most oaffected by atherosclerosis? | Endothelial cells |
| How does atherosclerosis affect endothelial cell function? | Impedes ability to maintain local vasoconstriction (maintains blood pressure), Maintain selective permeability barrier, control the formation and dissolution of thrombi, regulation of cell growth (smooth muscle), regulation of inflammatory responses and maintenance of extra cellular matrix lipoprotein |
| Define atherosclerosis | the hardening of the arteries because of plaque build up |
| True or false: an initiating event such as damage to endothelial cells is required for atherosclerosis to start? | true |
| What are the most common sites of atherosclerosis? | Abdominal aorta and iliac arteries (around belly button) Proximal coronary arteries (heart) Thoracic aorta, femoral arteries and popliteal arteries (down the leg) Internal Carotid Arteries (neck) Vertebral, basilar, middle cerebral arteries (back/ neck) |
| True or false: atherosclerosis tends to form where there branches and not very turbulent flow | False, it forms where there are branches and flow IS turbulent |
| What are atherosclerotic lesions? | Fatty streaks which everyone has, including children. They increase in number with age. They can decrease, stay the same or increase in size (atherosclerosis) depending on lifestyle factors predominantly |
| Describe the progression of atherosclerotic lesions | Accumulation of intracellular and extracellular lipids in vessel wall Oxidation by free radicals Initiation of inflammatory cell cascade Proliferation of vascular smooth muscle cells They form a fibrous cap which calcifies This makes lumen size smaller and less blood gets through This can cause occlusion or pre-dispose vessel to thrombus formation |
| Describe the two types of plaque | Stable (hard, thick cap) rich in smooth muscle cells Unstable (thin cap prone to rupture) rich in macrophages (foam cells) and inflammatory infiltrators with a large lipid rich core |
| True or False: 50% of presentations of atherosclerotic cardiovascular disease is with heart attack or sudden cardiac death? | True |
| Define Stenosis | Narrowing of the artery detectable by angiography |
| What does a thrombus overlying plaque in a coronary artery cause? | Occlusion and heart attack |
| What does a thrombus underlying plaque in a cerebral/ carotid artery lead to | Stroke if the plaque ruptures |
| What can rupture of plaque cause? | An embolus travelling to the brain, stroke |
| What do statin drugs do? | Decrease cholesterol synthesis which leads to increased uptake of cholesterol from the circulation |
| What are common treatment options for atherosclerosis? | Prophylactic meds (aspirin, statins) Stents Bypass surgery Vitamin supplements Endarterectomy (surgical removal of plaque) |
| Define Angina Pectoris | Chest pain occurring when the heart doesn't receive enough oxygenated blood bc of atherosclerosis in the coronary arteries (myocardial ischaemia) |
| What are symptoms of angina? | crushing chest pain which may radiate to back, shoulders, arms and neck Shortness of breath on exertion Sweating Lightheadedness Hypotension irregular pulse Indigestion |
| describe the difference between stable and unstable angina | Stable occurs on exertion and is treatable with rest, meds etc. Ischaemia is reversible and doesnt do permanent damage Unstable can happen without exertion, not relieved by medication and at risk of myocardial infarction (heart attack). |
| What causes unstable angina? | Fixed atherosclerotic narrowing with a non occlusive thrombus (occlusive thrombus leads to myocardial infarction) |
| What are the two types of myocardial infarction? | 1) Plaque rupture with thrombus 2) Vasospasm, endothelial dysfunction, fixed atherosclerosis and supply demand imbalance or supply demand imbalance alone. |
| What are the consequences of Myocardial infarction? | Decreased contractility, electrical instability - arrhythmia, heart block, cardiac arrest, tissue necrosis |
| What are the main priorities if a patient has myocardial infarction | M - Morphine for anxiety and pain O - Oxygen to address supply demand deficit A - Aspirin to prevent clots N - Nitrates to dilate vessels |
| What are the differences between stemi and nstemi heart attack? | Nstemi is partial thickness tissue death and stemi is full thickness tissue death (death in peri, myo and endo cardial tissue) |
| True or False: ventricular fibrillation is a non shockable rhythm? | False, ventricular fibrillation is the only shockable rhythm |
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