Atherosclerosis and Cardiovascular Disease Quiz

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Questions and Answers

What are the classical modifiable vascular risk factors identified by INTERHEART?

Hypertension, dyslipidemia, diabetes, smoking, sedentary behavior, central obesity, diet, alcohol, psychosocial (correct)

Obesity, lack of physical activity, poor diet, genetic predisposition, high stress levels

Smoking, high sugar intake, lack of sleep, hypertension, depression

High cholesterol levels, excessive alcohol consumption, sedentary lifestyle, environmental toxins exposure

At what age does the development of lipid-rich fibroinflammatory plaque in the arterial intima typically begin?

Early 20's (correct)

Late 40's

Late 30's

Late 50's

What are some common influence factors on the development of atherosclerosis?

Genetics and ethnicity

Lipids and environmental factors

Thrombosis and inflammation

Local hemodynamics and diffusely distributed vascular risk factors (correct)

Which medical conditions contribute to the inflammatory aspect of atherogenesis?

SLE, RA, PSORIASIS, IBD, COPD Signup and view all the answers

What is considered a paradox in terms of atherosclerosis development?

Diffusely distributed vascular risk factors but focal plaque development Signup and view all the answers

What are some factors that increase a person's atherosusceptibility according to the text?

Smoking, Cocaine use, Radiation exposure Signup and view all the answers

Which group is mentioned as having an increased atherosclerotic risk based on their ethnicity?

South Asians Signup and view all the answers

'A finely tuned interplay between all layers and all components of the vascular wall is required to maintain normal arterial function.' - Which concept from the text does this statement emphasize?

'Normal arterial physiology' Signup and view all the answers

'Acute event determined by plaque rupture or erosion' - What characteristic of atherogenesis is highlighted in this statement?

'Mechanism leading to acute cardiovascular events' Signup and view all the answers

What role do endothelial cells play in response to high shear stress?

Maintaining a non-thrombotic surface Signup and view all the answers

Which molecule is elaborated by endothelial cells to scavenge free radicals?

Superoxide dismutase Signup and view all the answers

What is the main function of smooth muscle cells in arteries?

Relax to allow blood flow Signup and view all the answers

What is the primary function of the extracellular matrix in arteries?

Provide structural integrity Signup and view all the answers

What aspect of atherosclerosis does Fibrillar collagen contribute to?

Structural strength Signup and view all the answers

Which risk factors did the INTERHEART study find predictive of coronary disease?

A combination of environmental, cultural, and genetic factors Signup and view all the answers

In the MESA study, what did the variance in asymptomatic patients reflect?

A confluence of environmental, cultural, and genetic differences Signup and view all the answers

'FRS' refers to a measure of prevalence. What does 'CAC' stand for in the context of CAC >75%ILE?

'Coronary Artery Calcification' Signup and view all the answers

According to Yusuf (Lancet 2004) and Nasir (Circ 2007), what percentage of prevalence is associated with FRS?

Between 10% and 20% Signup and view all the answers

What is the main characteristic of atherogenesis highlighted by the influence of local hemodynamics?

Focal plaque development Signup and view all the answers

How does atherogenesis typically begin in individuals with familial hypercholesterolemia?

In the early 20's Signup and view all the answers

Which vascular risk factor is NOT classified as a classical modifiable risk factor based on the INTERHEART study?

Alcohol consumption Signup and view all the answers

What role do lipids play in atherosusceptibility according to the text?

They increase susceptibility to atherosclerosis Signup and view all the answers

Among the listed inflammatory conditions, which one is NOT mentioned as contributing to the inflammatory aspect of atherogenesis?

HIV (Human Immunodeficiency Virus) Signup and view all the answers

What is the paradox regarding vascular risk factors and plaque development seen in atherogenesis?

Diffusely distributed risk factors lead to focal plaque formation Signup and view all the answers

Which group mentioned in the text is associated with an increased risk of atherosclerosis based on ethnicity?

South Asians Signup and view all the answers

What is the primary role of tight junctions in endothelial cells?

Maintaining a non-thrombotic luminal surface Signup and view all the answers

How do smooth muscle cells respond to metabolic needs in arteries?

By modulating the diameter/tone of the artery Signup and view all the answers

Which component of the extracellular matrix is responsible for the flexibility of arteries?

Elastin Signup and view all the answers

In the context of CAD prevalence, what does MESA stand for?

Multi-Ethnic Study of Atherosclerosis Signup and view all the answers

Which factor contributes significantly to the development of atherosclerosis based on polygenetic/epigenetic differences?

Ethnicity Signup and view all the answers

What is the main purpose of smooth muscle cells when arteries are in a relaxed state?

Modulating the artery diameter/tone Signup and view all the answers

What is the primary function of proteoglycans in the extracellular matrix?

Binding water and regulating molecular movement Signup and view all the answers

Study Notes

Classical Modifiable Vascular Risk Factors

INTERHEART identifies various classical modifiable risk factors, including hypertension, smoking, diabetes, dyslipidemia, and physical inactivity.

Lipid-Rich Fibroinflammatory Plaque

Development of lipid-rich fibroinflammatory plaque in the arterial intima typically begins in early adulthood.

Influencing Factors on Atherosclerosis

Common factors influencing atherosclerosis include hypertension, smoking, diabetes mellitus, high cholesterol levels, and sedentary lifestyle.

Inflammatory Conditions in Atherogenesis

Conditions such as diabetes, obesity, and chronic inflammatory diseases contribute to the inflammatory aspect of atherogenesis.

Atherosclerosis Development Paradox

A paradox exists where individuals with high levels of classical risk factors may not develop atherosclerosis while others with fewer risk factors can experience severe plaque buildup.

Increased Atherosusceptibility Factors

Factors increasing a person's susceptibility to atherosclerosis include age, genetic predisposition, and the presence of multiple risk factors.

Ethnic Group and Atherosclerotic Risk

Certain ethnic groups, such as South Asians, are mentioned as having an increased risk of developing atherosclerosis.

Vascular Wall Function Interplay

The statement emphasizes the concept of homeostasis, indicating the need for a finely tuned interplay among all layers and components of the vascular wall.

Atherogenesis Characteristics

The statement highlights the acute nature of events in atherogenesis, particularly those triggered by plaque rupture or erosion.

Endothelial Cells and Shear Stress

Endothelial cells play a crucial role in sensing and responding to high shear stress by maintaining vascular tone and regulating blood flow.

Molecule for Scavenging Free Radicals

Endothelial cells elaborate nitric oxide to scavenge free radicals, protecting the vascular wall from oxidative stress.

Smooth Muscle Cells Function

The main function of smooth muscle cells in arteries is to regulate vessel diameter and maintain blood flow through contraction and relaxation.

Extracellular Matrix Role

The primary function of the extracellular matrix in arteries is to provide structural support, regulate cell behavior, and facilitate cellular communication.

Fibrillar Collagen Contribution

Fibrillar collagen contributes to the mechanical strength and integrity of the arterial wall, crucial in atherosclerosis progression.

Predictive Risk Factors from INTERHEART

The INTERHEART study found that factors like smoking, obesity, hypertension, and diabetes are predictive of coronary disease.

MESA Study Findings

In the MESA study, variance in asymptomatic patients primarily reflected differences in genetic and lifestyle factors influencing atherosclerotic risk.

FRS and Prevalence Measure

FRS refers to the Framingham Risk Score, which measures the prevalence of cardiovascular risk factors.

CAC Definition

'CAC' stands for Coronary Artery Calcium, an important marker assessed for cardiovascular risk >75%ile.

FRS Prevalence Percentages

According to Yusuf and Nasir, a prevalence associated with FRS can be approximately 20-30% for significant cardiovascular events.

Local Hemodynamics in Atherogenesis

The influence of local hemodynamics is critical, emphasizing blood flow patterns and shear stress in the initiation of atherosclerosis.

Familial Hypercholesterolemia Atherogenesis

Atherogenesis in individuals with familial hypercholesterolemia typically begins at a young age due to very high levels of low-density lipoprotein (LDL).

Non-Classical Modifiable Risk Factor

Factors such as age and genetics are not classified as classical modifiable risk factors under the INTERHEART study.

Role of Lipids in Atherosusceptibility

Lipids, particularly LDL cholesterol, play a significant role in the susceptibility to atherosclerosis, leading to plaque formation.

Inflammatory Conditions Not Mentioned

Conditions like rheumatoid arthritis or lupus are not specifically pointed out as contributing to inflammatory aspects in the text.

Vascular Risk Factors Paradox

There exists a paradox where low-risk patients may experience significant disease while high-risk patients may remain free of symptoms for extended periods.

Ethnic Risk Group for Atherosclerosis

South Asian populations are highlighted as being associated with a higher risk of developing atherosclerosis.

Tight Junctions Function

The primary role of tight junctions in endothelial cells is to maintain the integrity of the blood-brain barrier and control permeability.

Smooth Muscle Response

Smooth muscle cells adjust vessel tone and diameter in response to metabolic needs, ensuring proper blood flow during increased activity.

Extracellular Matrix Flexibility

Elastin is responsible for providing flexibility to arteries, allowing them to withstand pulsatile blood flow.

MESA Definition

MESA stands for Multi-Ethnic Study of Atherosclerosis, which examines cardiovascular risk across different ethnic groups.

Genetic Factors in Atherosclerosis

Polygenic and epigenetic differences significantly contribute to the development of atherosclerosis.

Smooth Muscle Cells in Relaxed State

When arteries are in a relaxed state, smooth muscle cells primarily assist in maintaining vessel diameter for optimal blood flow.

Proteoglycans Function

Proteoglycans in the extracellular matrix serve multiple functions, including maintaining hydration, structural integrity, and mediating cell signaling.

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Description

Test your knowledge on atherosclerosis and cardiovascular disease, including the processes of atherogenesis, clinical risk factors, and cell biology related to atherosclerosis. Understand how these factors can be modified to improve cardiovascular outcomes.