Term
| What is a generic name for diseases affecting arteries of different sizes leading to hardening and thickening? |
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Definition
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Term
| Name the different forms of arteriosclerosis. |
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Definition
| artherosclerosis, monckeberg's sclerosis, and arteriolosclerosis |
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Term
| What is artherosclerosis? |
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Definition
| an intimal disease involving the large elastic arteries and the medium-sized muscular arteries with characteristic accumulation of lipid in the lesion |
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Term
| Besides lipids, what else accumulates inside the vessel in the process of atherosclerosis? |
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Definition
| CTs and various blood products |
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Term
| What are the complications of artherosclerosis? |
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Definition
| hemorrhage into the lesion, thrombosis superimposed on the lesion, and degeneration of the media beneath the intimal lesion |
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Term
| What are the hallmarks of atherosclerosis? |
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Definition
its intimal
characterized by fat accumulation |
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Term
| Which form of ateriosclerosis is the most prominent in causing clinically significant disease? |
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Definition
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Term
| What's another name for Monckeberg's sclerosis? |
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Definition
| monckeberg's medial calcific sclerosis |
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Term
| What is Monckeberg's sclerosis? |
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Definition
| a form of medial disease characterized by calcification of the muscular arteries |
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Term
| Where in the body does Monckeberg's sclerosis occur? |
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Definition
| arteries of the extremities both the upper and lower, including the radial artery and branches of the femoral arteries |
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Term
| What are the clinical sequalae of monckeberg sclerosis? |
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Definition
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Term
| What are the distinguishing features of monckeberg sclerosis in comparison to atherosclerosis? |
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Definition
Monckeberg is mainly calcificaiton in the media with no sequelae
atherosclerosis is fat deposition in the intima with clinical sequelae |
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Term
| T/F Feeling a person's radial artery can give you a rough estimate of the extent of their atherosclerosis. |
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Definition
| False! Monckeberg's sclerosis is what you would feel in the arter and is unrelated to atherosclerosis |
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Term
| What do atherosclerosis and Monckeberg sclerosis have in common? |
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Definition
| they both increase with age |
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Term
| T/F Monckeberg's medial calcific sclerosis does not usually involve the coronary arteries. |
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Definition
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Term
| What is arteriolosclerosis? |
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Definition
| thickening, fibrosis, hyalinization, and narrowing of arterioles with hypertension. It is found in arterioles all over the body but most oftenly seen in the kidneys |
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Term
| Which type of arterioclerosis occurs mainly in the brain and kidney? |
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Definition
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Term
| Which type of arterioclerosis occurs mainly in the extremities? |
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Definition
| monckeberg medial calcific sclerosis |
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Term
| Which type of arterioclerosis occurs mainly in the coronary, cerebral, limbs, and aorta? |
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Definition
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Term
| Endothelial dysfunction and activation that results in arteriosclerosis is manifest by... |
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Definition
| increased endothelial permeability, enhanced leukocyte adhesion, and alterations and expression of a number of endothelial gene products |
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Term
| What causes endothelial alterations that lead to ateriosclerosis? |
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Definition
| 1) elevated serum lipids 2) hemodynaic forces that accompany normal circulatory function |
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Term
| Serum lipids lead to lesion formation through _______ stress on the endothelium. |
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Definition
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Term
| Whcih cells can form foam cells? |
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Definition
| macrophages and smooth muscle cells |
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Term
| What causes cholesterol efflux from an atheromatous plaque? |
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Definition
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Term
| Describe the natural progression of atherosclerosis. |
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Definition
| fatty streak -> fibrous plaque -> calcification -> complicated lesioln- hemorrhage, ulceration, thrombosis |
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Term
| What are some common clinical issues that result from atherosclerosis? |
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Definition
| myocardial infarct, cerebral infarct, gangrene of extremities, and abdominal aortic aneurysm |
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Term
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Definition
| pathologic study of atherosclerosis in youth--study happening at LSU |
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Term
| Ischemic heart disease due to diminished blood supply can be due to... |
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Definition
| 1) atherosclerosis and thrombosis 2) thromboemboli 3) coronary artery spasm 4) decreased cardiac output 5) decreased blood pressure 6) others (arteritis, dissection, luetic, anomalous origin) |
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Term
| What are the causes of ischemic heart disease due to decreased oxygen availability? |
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Definition
| anemia, carbon monoxide, and cyanide |
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Term
| Namethe causes of ischemic heart disease due to increased oxygen demand. |
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Definition
| HTN, valvular stenosis (+/- insufficiency), hyperthyroidism, catecholamines |
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Term
| What is the underlying problem of ischemic heart disease in >90% of cases? |
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Definition
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Term
| T/F Risk factors for atherosclerosis are also risk factors for IHD. |
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Definition
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Term
| What are the different clinical outcomes of ischemic heart disease? |
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Definition
| angina pectoris (either stable, unstable, or prinzmetal), sudden death, chronic ischemic heart disease with failure, myocardial infarct |
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Term
| What are the MAJOR and MODIFIABLE risk factors for coronary heart disease and atherosclerosis? |
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Definition
HIGH LDL and VLDL cholesterol
LOW HDL cholesterol
cigarrette smoking
HIGH blood pressure
glucose intolerance and diabetes
overweight and obesity |
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Term
| What is a negative risk factor for CHD and atherosclerosis? |
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Definition
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Term
| Name the minor/unmodifiable risk factors for coronary heart disease. |
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Definition
| age, male gender, family history (genetics/living habits), sedentary life style |
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Term
| What are some additional reported CHD risk factors? |
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Definition
| certain blood lipids such as apolipoprotein B, ,Lipoprotein A, small dense LDL, homocysteine, fibrinogen, C-reactive protein |
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Term
| How many people have an MI in US each year? |
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Definition
| 1.1 million people (370,000 die of MI, 250,000 die within 1 hr) |
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Term
| How many people in the US have a history of MI and/or angina? |
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Definition
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Term
| What fraction of men and women develop CHD by age 60? |
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Definition
| 1 in 5 men and 1 in 17 women |
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Term
| How many americans are eligible for lipid modification? |
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Definition
| 52 million (36 million qualify for statin therapy) |
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Term
| What are the top four causes of death in the US? |
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Definition
| heart disease, cancer, cerebrovascular disease, respiratory disease |
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Term
| At what age are men said to have a higher CHD risk? women? |
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Definition
| >45, >55 (post-menopausal) |
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Term
| At what blood pressure is your risk for CHD increased? |
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Definition
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Term
| At what cholesterol levels are your risk for heart disease increased? |
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Definition
| total cholesterol > 240 mg/dl LDL cholesterol > 160 mg/dl HDL cholesterol < 40 mg/dl |
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Term
| At what level is C reactive protein a risk for CHD? |
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Definition
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Term
| At what level is Lp (a) a risk factor for CHD? |
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Definition
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Term
| At what level is triglyceride a risk factor for CHD? |
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Definition
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Term
| At what level is remnant lipoprotein cholesterol a risk factor for CHD? |
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Definition
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Term
| At what level is elevated homocysteine a risk factor for CHD? |
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Definition
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Term
| What waist circumference defines metabolic syndrome? |
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Definition
> 102 cm/40 inches for men
> 88 cm/35 in for women |
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Term
| What HDL-C level is associated with metabolic syndrome? |
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Definition
| men < 40 mg/dL, women < 50 mg/dL |
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Term
| What blood pressure is associated with metabolic syndrome? |
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Definition
more than or equal to 130 systolic
more than or equal to 85 diastolic |
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Term
| What fasting glucose is associated with metabolic syndrome? |
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Definition
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Term
| How do you diagnose metabolic syndrome? |
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Definition
| when 3 or more of the following criteria are present: abdominal obesity, TG, HDL-C, blood pressure, fasting glucose |
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Term
| What metabolic dyfunctions is visceral obesity associated with? |
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Definition
| insulin resistance and increased free fatty acids |
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Term
| What does insulin resistance and elevated free fatty acids lead to? |
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Definition
type 2 DM, glycemic disorders
dyslipidemia (low HDL, small dense LDL particles, hypertriglyceridemia)
hypertension, impaired thrombolysis (increased PAI-1), endothelial dysfunction/inflammation (increased CRP, MMP-9), and microalbuminuria |
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Term
| Coronary atherosclerotic lesions with a superimposed occlusive episode leads to... |
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Definition
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Term
| What are the major and minor risk factors for IHD? |
|
Definition
MAJOR: hyperlipidemia, HTN, smoking
MINOR: diabetes, gout, obesity, and personality |
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Term
| What are some examples of primary intervention to prevent heart disease? |
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Definition
| screen for risk factors, prudent diet, control HTN, don't smoke |
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Term
| What are some secondary interventions to combat heart disease? |
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Definition
| drugs, diet, surgery, stop smoking |
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Term
| What are the characteristics of a transmural MI? |
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Definition
| solid, usually in distribution of narrowed or occluded coronary artery, may lead to shock, pericarditis frequent, and may result in aneurysm |
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Term
| What are the characteristics of a subendocardial myocardial infarct? |
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Definition
| patchy circumferential, often result of shock, no periarditis, no aneurysm formation |
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Term
| What happens in the first 1-3 days of MI? |
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Definition
| coagulation necrosis with nuclei changes and neutrophilic infiltrate |
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Term
| What happens in the 3-7 days following an MI? |
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Definition
| early phagocytosis of dying neutrophils and fibers |
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Term
| What happens in the 7-10 days following an MI? |
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Definition
| granulation tissue at borders |
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Term
| What happens in the 10-14 days following an MI? |
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Definition
| well-established granulation tissue and collagen |
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Term
| What happens in > 2 weeks following an MI? |
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Definition
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Term
| What are some complications of an MI? |
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Definition
| contractile dysfunction, arrhythmias, myocardial rupture, pericarditis, mural thrombus +/- embolus, ventricular aneurysm |
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Term
| What procedures commonly precipitate a bacterial endocarditis? |
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Definition
| dental manipulation and urinary instrumentation |
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Term
| What blood test can help diagnose bacterial endocarditis? |
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Definition
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Term
| What are the morphologic features of giant cell arteritis or temporal arteritis? |
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Definition
| disruption of elastic lamina, most intense reaciton in intima-media; giant cells engulf elastic fiber remnants, occasionally thrombi |
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Term
| Which vessels are involved in giant cell arteritis? |
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Definition
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Term
| What are the morphologic features of Buerger's disease? |
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Definition
| thrombi with microabscesses; acute inflammatory reaction that permeatues artery wall but underlying architecture preserved |
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Term
| Which vessels are affected by giant cell arteritis? |
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Definition
| muscular arteries (usually temporal, opthalmic, and cranial arteries; may be systemic) |
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