Podcast
Questions and Answers
Which of the following statements correctly defines the ApoB/ApoA1 ratio?
Which of the following statements correctly defines the ApoB/ApoA1 ratio?
Familial Hypercholesterolaemia is caused by a mutation in the LDLR gene.
Familial Hypercholesterolaemia is caused by a mutation in the LDLR gene.
True (A)
What physical signs are associated with Familial Hypercholesterolaemia?
What physical signs are associated with Familial Hypercholesterolaemia?
Tendon xanthomas, corneal arcus
Atheroma refers to a build-up of ________ substance in your arteries over time.
Atheroma refers to a build-up of ________ substance in your arteries over time.
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Match the following concepts with their definitions:
Match the following concepts with their definitions:
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What is one possible cause of ischaemia?
What is one possible cause of ischaemia?
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Smooth muscle cells do not play a role in plaque formation within blood vessels.
Smooth muscle cells do not play a role in plaque formation within blood vessels.
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At what age do 50% of males with Familial Hypercholesterolaemia show symptomatic Coronary Heart Disease (CHD)?
At what age do 50% of males with Familial Hypercholesterolaemia show symptomatic Coronary Heart Disease (CHD)?
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What occurs when a thrombus breaks off from a blood vessel?
What occurs when a thrombus breaks off from a blood vessel?
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In patients with stable angina, blood flow increases during exercise despite the presence of atherosclerotic plaque.
In patients with stable angina, blood flow increases during exercise despite the presence of atherosclerotic plaque.
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What medication is commonly used to treat stable angina?
What medication is commonly used to treat stable angina?
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An inflammation of blood vessel walls is known as __________.
An inflammation of blood vessel walls is known as __________.
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Match the following medications with their effects:
Match the following medications with their effects:
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What is a common adverse effect of nitrate therapy?
What is a common adverse effect of nitrate therapy?
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Oxygen is routinely used to relieve hypoxia in patients with stable angina.
Oxygen is routinely used to relieve hypoxia in patients with stable angina.
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What physiological changes occur during exercise in a normal person regarding blood vessel response?
What physiological changes occur during exercise in a normal person regarding blood vessel response?
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Flashcards
Embolus
Embolus
A thrombus that breaks off, blocking a blood vessel.
Vasculitis
Vasculitis
Inflammation of blood vessel walls affecting blood flow.
Stable Angina
Stable Angina
Chest pain due to oxygen demand exceeding supply during exertion.
Glyceryl Trinitrate (GTN)
Glyceryl Trinitrate (GTN)
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Myocardial Oxygen Supply
Myocardial Oxygen Supply
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Nitrates
Nitrates
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Postural Hypotension
Postural Hypotension
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Morphine/Diamorphine
Morphine/Diamorphine
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ApoB/ApoA1 ratio
ApoB/ApoA1 ratio
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Atherosclerosis process
Atherosclerosis process
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Familial Hypercholesterolaemia
Familial Hypercholesterolaemia
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Ischaemia
Ischaemia
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Infarction
Infarction
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Atheroma
Atheroma
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Thrombus
Thrombus
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Coronary artery spasm
Coronary artery spasm
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Study Notes
Atherosclerosis and Heart Disease
- Atherosclerosis involves plaque buildup in arteries, narrowed blood vessels.
- Plaque is composed of cholesterol, lipids, smooth muscle cells, and inflammatory cells.
- Different types of lipoproteins have varying atherosclerosis risk.
- Chylomicrons, VLDL, IDL, and LDL are associated with different levels of risk.
- High levels of LDL and low levels of HDL increase risk.
- The ApoB/ApoA1 ratio measures the ratio of bad LDL to good HDL. A higher ratio indicates a higher risk.
- The artery wall has layers; endothelium, internal elastic lamina, smooth muscle cells, and external elastic lamina.
- Plaque formation begins with LDL getting into the subendothelial space and becoming oxidized.
- Macrophage cells engulf the oxidized LDL, forming foam cells.
- Smooth muscle cells migrate and proliferate, contributing to the plaque.
- Inflammation, lipid, and necrotic cells are part of the plaque's structure.
- The plaque may enlarge and cause a fibrous capsule protruding into the vessel.
- Plaque buildup can lead to various heart conditions.
Familial Hypercholesterolemia
- Familial hypercholesterolemia is a genetic condition characterized by high cholesterol levels.
- It is caused by mutations in genes associated with LDL receptor function.
- The prevalence rate is approximately 1 in 250 people.
- People with familial hypercholesterolemia typically exhibit elevated LDL-cholesterol (9-12mmol/L).
- Physical signs may include tendon xanthomas, corneal arcus, and possibly planar or natal cleft xanthomas, and in some cases aortic stenosis.
- This condition significantly increases the risk of coronary heart disease (CHD).
- 50% of men develop CHD by age 50 and 50% of women by age 60.
Ischemic Heart Disease
- Ischemia is inadequate blood flow to tissue, causing insufficient oxygen.
- Types of Ischemic Heart Disease include Atherosclerosis, Thrombus, Spasms, Embolism, and Vasculitis.
- Atheroma is the build-up of fatty substances in the arteries over time.
- A thrombus is a blood clot that forms inside a blood vessel or a chamber of the heart.
- Spasm describes the temporary tightening of the muscles in an artery wall.
- An embolus is a thrombus that detaches from a blood vessel
- Vasculitis is blood vessel wall inflammation causing stenosis, occlusion, aneurysm, or rupture.
Myocardial Oxygen Supply
- Myocardial oxygen supply depends on the O2-carrying blood capacity and coronary blood flow.
- Coronary blood flow relies on perfusion pressure, vascular, and external arterial compression.
- Local metabolites, endothelium, and neural mechanisms regulate oxygen supply.
- Myocardial oxygen demand depends on wall stress (blood pressure) and heart rate.
- The heart rate and contractility factor into the demand for oxygen.
Angina
- Angina is chest pain or discomfort caused by inadequate blood flow to the heart muscle.
- In a normal subject, blood vessels dilate during exercise.
- In angina, blood flow may be limited, despite dilation during exercise, limiting oxygen.
- This situation is common in patients with atherosclerosis.
Treating Stable Angina
- Glyceryl trinitrate or isosorbide mononitrate are used to relax vascular smooth muscle.
- These medications reduce afterload and central venous pressure.
- Nitrates, activate guanylyl cyclase, increasing cGMP and relaxing smooth muscle in a therapeutic dose.
How to Treat Myocardial Infarction
- Relieve hypoxia by administering oxygen (but not routine).
- Pain relief (Morphine/Diamorphine with antiemetic)
- Reduce cardiac workload (Nitrates)
- Reduce the risk of clot formation (Antiplatelet drugs, such as Aspirin or Clopidogrel)
Drug Treatments for Myocardial Infarction
- Beta blockers increase myocardial perfusion and help prevent arrhythmias.
- ACE inhibitors (Captopril) improve survival, especially in heart failure risk.
- Anticoagulants (like heparin) help prevent further thrombus formation.
- Other useful drugs include Nitrates, Antiarrhythmics, and Statins (lipid-lowering drugs).
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Description
This quiz explores the mechanisms of atherosclerosis, focusing on plaque formation and its impact on heart disease. Key topics include the types of lipoproteins, role of LDL and HDL, and the structure of artery walls. Test your understanding of how these factors contribute to cardiovascular health.
