CV

Question 1

types of arteriosclerosis

Answer 1

1. atherosclerosis
2. monckeberg’s medial calcific sclerosis
3. arteriolosclerosis

Question 2

two principal mechanisms of vascular disease

Answer 2

• narrowing or obstruction of vascular lumina

- weakening of vascular walls, leading to dilation and/or rupture

Question 3

non-modifiable/ constitutional risk factors of arteriosclerosis

Answer 3

age, gender, genetics

Question 4

potentially modifiable risk factors of arteriosclerosis

Answer 4

1. cigarette smoking
2. diabetes mellitus
3. hypertension
4. hypercholesterolemia

Question 5

additional risk factors of arteriosclerosis

Answer 5

1. inflammation (CRP levels- inflammatory mediator)
2. hyperhomocysteinemia
3. lipoprotein (a) levels
4. metabolic syndrome (obesity)
5. type A personality (stress)
6. lack of exercise

Question 6

common sites of atheroma formation

Answer 6

1. major arterial branch points
2. abdominal aorta
3. coronary arteries
4. popliteal arteries
5. carotid arteries
6. cerebral arteries

Question 7

complications of atherosclerosis

Answer 7

1. IHD
2. cerebral vascular accident/infarct (stroke)
3. gangrene
4. nephrosclerosis
5. aneurysm formation
6. renal artery stenosis

Question 8

in hyaline arteriolosclerosis there is thickening of the ____; occurs in ____ and ____

Answer 8

basement membrane; hypertension; diabetes mellitus

Question 9

in hyperplastic arteriolosclerosis (proliferative), there is ____ intimal thickening ; occurs in _____

Answer 9

fibrocellular; malignant hypertension

Question 10

3 steps in the atherosclerosis response to injury hypothesis

Answer 10

1. endothelial injury
2. accumulation of lipids
3. monocyte adhesion

Question 11

plaques contain:

Answer 11

collagen, lipid, myofibroblasts, macrophages, neovascularization

Question 12

plaques have a ____ cap, composed of _____ and ____; it develops over a central core of _____ with _____

Answer 12

fibrous; myofibroblasts (smooth m. cells); collagen; lipid/cellular debris; cholesterol

Question 13

progressive changes in plaques include:

Answer 13

ulceration, calcification
fissure formation
thrombosis, embolization
hemorrhage into the plaque from neovascularization
medial weakening

Question 14

fatty streaks in infants/children are characterized by ____ cells in the ____

Answer 14

lipid-laden; intima

Question 15

symptoms of hypertension

Answer 15

• none (early) at low and moderate hypertension
• headaches
• dizziness
• fatigue
• palpitations

Question 16

contributing factors to essential hypertension

Answer 16

genetics, stress, obesity, increased salt intake, inactivity, cigarette smoking

Question 17

Thickening of the left ventricular wall at the expense of the left ventricular chamber with little or no increase in the outside cardiac dimensions

Answer 17

concentric hypertrophy

Question 18

pathologic complications of hypertension

Answer 18

• concentric L ventricular hypertrophy (compensated)
• L ventricular hypertrophy plus dilation and CHF (decompensated)
• atherosclerosis (which leads to IHD, stroke, and ischemic injury in other organs)
• arteriolosclerosis (which leads to retinal injury and kidney damage (nephrosclerosis-renal failure)

Question 19

another complication from hypertension is _____- longitudinal tear in the media

Answer 19

dissecting aortic hematoma

Question 20

pathogenesis of hypertension (environmental and hereditary factors)

Answer 20

1. peripheral vascular resistance (vasoconstriction)

2. reduced Na excretion > salt and water retention > increased plasma volume and cardiac output

Question 21

6 principal mechanisms of heart disease

Answer 21

1. failure of the pump
2. flow obstruction
3. shunted flow
4. “leaky” flow (bad valves)
5. conduction disorders
6. rupture of the heart/major vessel