61 Questions
Which age group has the highest incidence of myocardial infarction?
40-60 years
Which group is relatively protected against atherosclerosis and its consequences compared to age-matched men?
Premenopausal women
Which factors can predispose premenopausal women to atherosclerosis and its complications?
Diabetes, hyperlipidemia, or severe hypertension
At what stage of life does the incidence of atherosclerosis-related diseases increase in women?
After menopause
What is the effect of estrogen replacement therapy on cardiovascular risk in postmenopausal women?
Increases cardiovascular risk
Which factor is sufficient to induce atherosclerotic lesions in the absence of other risk factors?
Hyperlipidemia
Which lipoprotein is considered a major risk factor for atherosclerosis?
Low-density lipoprotein (LDL)
Which group has a higher incidence of atherosclerosis-related diseases at older ages?
Postmenopausal women
Which lipids are dominant in plaques implicated in atherogenesis?
Cholesterol
What is the effect of lowering serum cholesterol on atherosclerosis?
It causes regression of some plaques
Which factor increases the risk of ischemic heart disease by approximately 60% compared to normotensive populations?
Hypertension
What is the effect of prolonged cigarette smoking on the death rate from ischemic heart disease?
It increases the death rate
Which condition induces hypercholesterolemia and markedly increases the risk of atherosclerosis?
Diabetes mellitus
What is the incidence of Myocardial Infraction in people with diabetes compared to normoglycemic individuals?
Twice as high
According to the response-to-injury hypothesis, what is the chronic inflammatory response of the arterial wall to?
Endothelial injury
Which of the following is NOT one of the 4 key players in the response-to-injury hypothesis?
Cardiac muscle cells
What are the dominant lipids found in plaques implicated in atherogenesis?
Cholesterol
Which of the following is the result of endothelial cell injury in atherosclerosis?
Increased leukocyte adhesion
What is the effect of increased cholesterol on endothelial cell function?
Impaired endothelial cell function
What is the role of oxidized LDL in atherosclerosis?
Stimulates release of factors that recruits monocytes
Which of the following is true about fatty streaks in atherosclerosis?
Do not cause significant flow disturbance
What happens during the conversion of fatty streaks into mature atheromas?
Activation of inflammatory cells
Which site is typically more severely affected by atherosclerosis compared to the coronary arteries?
Infrarenal abdominal aorta
What is the effect of plaque inflammation on collagen synthesis and degradation?
Increase collagen degradation
Which lipids are dominant in plaques implicated in atherogenesis?
Cholesterol esters
Which layer(s) of the artery are involved in a true aneurysm?
All three layers (intima, media, adventitia)
What is the main difference between a true aneurysm and a false (pseudoaneurysm)?
True aneurysm involves all three layers of the artery, while false aneurysm involves only the intima
How does an arterial dissection occur?
Blood gains entry to arterial wall through surface defect and pushes layers apart
Which arteries are typically spared in thoracic aortic aneurysms?
Upper extremity arteries
What is the term for a defect in the vascular wall that leads to an extravascular hematoma communicating with the intravascular space?
False aneurysm
What are aneurysms?
Dilations of the blood vessels or the heart
Which two factors are the most important causes of endothelial cell injury?
Hemodynamic forces and hypercholesterolemia
Where do plaques tend to occur in hemodynamic forces?
Branch points and ostia
What is the effect of increased cholesterol on endothelial cell function?
It impairs endothelial cell function
What do activated macrophages produce that drives LDL oxidation and smooth muscle cell proliferation?
Toxic oxygen species
Where are atherosclerotic sites typically more severe?
Abdominal aorta
Which syndrome is caused by mutations in fibrillin?
Marfan syndrome
What is the most common cause of Abdominal Aortic Aneurysms (AAA)?
Atherosclerosis
Which gender is more commonly affected by Abdominal Aortic Aneurysms (AAA)?
Men
Which group has a higher risk of Abdominal Aortic Aneurysms (AAA)?
Smokers
What can cause ischemia of arterial smooth muscle cells (SMC) in the context of Abdominal Aortic Aneurysms (AAA)?
Atherosclerosis and hypertension
What is the consequence of Abdominal Aortic Aneurysm (AAA) rupture?
Potential rupture leading to fatal hemorrhage
What is the main cause of connective tissue degradation in Abdominal Aortic Aneurysms (AAA)?
Proteolytic enzymes released from inflammatory infiltrates in atherosclerotic lesions
What can obstruction of vessels branching off the aorta in Abdominal Aortic Aneurysms (AAA) lead to?
Ischemia of kidneys, spinal cord, and GI tract
Which of the following is a cause of inadequate/abnormal connective tissue synthesis, specifically with defective elastin and collagen synthesis?
Mutations in TGF-β
Which type of collagen is defective in Ehlers-Danlos syndrome?
Type III
Which enzyme degrades arterial connective tissue in the wall?
Protease
Which of the following is a potential complication of Abdominal Aortic Aneurysms (AAA)?
All of the above
Which of the following is a major risk factor for Thoracic Aortic Aneurysms?
All of the above
What are the signs and symptoms of Thoracic Aortic Aneurysms?
All of the above
Which age group is more likely to develop Aortic Dissection?
40-60 years with hypertension
What is the morphology of Aortic Dissection?
Intimal tear leading to blood-filled channel within aortic wall
Which artery may be compressed by blood dissecting upward from a tear with Aortic Dissection?
Right carotid artery
What symptoms may patients with Aortic Dissection present with?
All of the above
What can a massive amount of hemorrhage due to Aortic Dissection lead to?
Hemopericardium
What is a potential complication of Aortic Dissection?
All of the above
What are the clinical features of Aortic Dissection?
Sudden onset of excruciating, tearing pain, radiating to back between scapulae
What is the effect of Aortic Dissection on the carotid artery?
Compression by blood dissecting upward from a tear
Which layer of the artery is usually affected by Aortic Dissection?
Media
What inhibits the propagation of dissecting hematoma in Aortic Dissection?
Fibrosis
In the presence of substantial atherosclerosis or other causes of medial scarring, Aortic Dissection is...
Unusual
Test your knowledge on atherosclerosis and its impact on premenopausal women. Discover why women in this stage of life are relatively protected against this cardiovascular condition compared to men.
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