Atherosclerosis and Aneurysms
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Questions and Answers

Which age group has the highest incidence of myocardial infarction?

  • 60-80 years
  • 30-40 years
  • 20-30 years
  • 40-60 years (correct)
  • Which group is relatively protected against atherosclerosis and its consequences compared to age-matched men?

  • Premenopausal women (correct)
  • Postmenopausal women
  • Menopausal women
  • Elderly women
  • Which factors can predispose premenopausal women to atherosclerosis and its complications?

  • Old age, lack of exercise, or poor diet
  • Obesity, smoking, or sedentary lifestyle
  • Family history of atherosclerosis, high cholesterol, or stress
  • Diabetes, hyperlipidemia, or severe hypertension (correct)
  • At what stage of life does the incidence of atherosclerosis-related diseases increase in women?

    <p>After menopause</p> Signup and view all the answers

    What is the effect of estrogen replacement therapy on cardiovascular risk in postmenopausal women?

    <p>Increases cardiovascular risk</p> Signup and view all the answers

    Which factor is sufficient to induce atherosclerotic lesions in the absence of other risk factors?

    <p>Hyperlipidemia</p> Signup and view all the answers

    Which lipoprotein is considered a major risk factor for atherosclerosis?

    <p>Low-density lipoprotein (LDL)</p> Signup and view all the answers

    Which group has a higher incidence of atherosclerosis-related diseases at older ages?

    <p>Postmenopausal women</p> Signup and view all the answers

    Which lipids are dominant in plaques implicated in atherogenesis?

    <p>Cholesterol</p> Signup and view all the answers

    What is the effect of lowering serum cholesterol on atherosclerosis?

    <p>It causes regression of some plaques</p> Signup and view all the answers

    Which factor increases the risk of ischemic heart disease by approximately 60% compared to normotensive populations?

    <p>Hypertension</p> Signup and view all the answers

    What is the effect of prolonged cigarette smoking on the death rate from ischemic heart disease?

    <p>It increases the death rate</p> Signup and view all the answers

    Which condition induces hypercholesterolemia and markedly increases the risk of atherosclerosis?

    <p>Diabetes mellitus</p> Signup and view all the answers

    What is the incidence of Myocardial Infraction in people with diabetes compared to normoglycemic individuals?

    <p>Twice as high</p> Signup and view all the answers

    According to the response-to-injury hypothesis, what is the chronic inflammatory response of the arterial wall to?

    <p>Endothelial injury</p> Signup and view all the answers

    Which of the following is NOT one of the 4 key players in the response-to-injury hypothesis?

    <p>Cardiac muscle cells</p> Signup and view all the answers

    What are the dominant lipids found in plaques implicated in atherogenesis?

    <p>Cholesterol</p> Signup and view all the answers

    Which of the following is the result of endothelial cell injury in atherosclerosis?

    <p>Increased leukocyte adhesion</p> Signup and view all the answers

    What is the effect of increased cholesterol on endothelial cell function?

    <p>Impaired endothelial cell function</p> Signup and view all the answers

    What is the role of oxidized LDL in atherosclerosis?

    <p>Stimulates release of factors that recruits monocytes</p> Signup and view all the answers

    Which of the following is true about fatty streaks in atherosclerosis?

    <p>Do not cause significant flow disturbance</p> Signup and view all the answers

    What happens during the conversion of fatty streaks into mature atheromas?

    <p>Activation of inflammatory cells</p> Signup and view all the answers

    Which site is typically more severely affected by atherosclerosis compared to the coronary arteries?

    <p>Infrarenal abdominal aorta</p> Signup and view all the answers

    What is the effect of plaque inflammation on collagen synthesis and degradation?

    <p>Increase collagen degradation</p> Signup and view all the answers

    Which lipids are dominant in plaques implicated in atherogenesis?

    <p>Cholesterol esters</p> Signup and view all the answers

    Which layer(s) of the artery are involved in a true aneurysm?

    <p>All three layers (intima, media, adventitia)</p> Signup and view all the answers

    What is the main difference between a true aneurysm and a false (pseudoaneurysm)?

    <p>True aneurysm involves all three layers of the artery, while false aneurysm involves only the intima</p> Signup and view all the answers

    How does an arterial dissection occur?

    <p>Blood gains entry to arterial wall through surface defect and pushes layers apart</p> Signup and view all the answers

    Which arteries are typically spared in thoracic aortic aneurysms?

    <p>Upper extremity arteries</p> Signup and view all the answers

    What is the term for a defect in the vascular wall that leads to an extravascular hematoma communicating with the intravascular space?

    <p>False aneurysm</p> Signup and view all the answers

    What are aneurysms?

    <p>Dilations of the blood vessels or the heart</p> Signup and view all the answers

    Which two factors are the most important causes of endothelial cell injury?

    <p>Hemodynamic forces and hypercholesterolemia</p> Signup and view all the answers

    Where do plaques tend to occur in hemodynamic forces?

    <p>Branch points and ostia</p> Signup and view all the answers

    What is the effect of increased cholesterol on endothelial cell function?

    <p>It impairs endothelial cell function</p> Signup and view all the answers

    What do activated macrophages produce that drives LDL oxidation and smooth muscle cell proliferation?

    <p>Toxic oxygen species</p> Signup and view all the answers

    Where are atherosclerotic sites typically more severe?

    <p>Abdominal aorta</p> Signup and view all the answers

    Which syndrome is caused by mutations in fibrillin?

    <p>Marfan syndrome</p> Signup and view all the answers

    What is the most common cause of Abdominal Aortic Aneurysms (AAA)?

    <p>Atherosclerosis</p> Signup and view all the answers

    Which gender is more commonly affected by Abdominal Aortic Aneurysms (AAA)?

    <p>Men</p> Signup and view all the answers

    Which group has a higher risk of Abdominal Aortic Aneurysms (AAA)?

    <p>Smokers</p> Signup and view all the answers

    What can cause ischemia of arterial smooth muscle cells (SMC) in the context of Abdominal Aortic Aneurysms (AAA)?

    <p>Atherosclerosis and hypertension</p> Signup and view all the answers

    What is the consequence of Abdominal Aortic Aneurysm (AAA) rupture?

    <p>Potential rupture leading to fatal hemorrhage</p> Signup and view all the answers

    What is the main cause of connective tissue degradation in Abdominal Aortic Aneurysms (AAA)?

    <p>Proteolytic enzymes released from inflammatory infiltrates in atherosclerotic lesions</p> Signup and view all the answers

    What can obstruction of vessels branching off the aorta in Abdominal Aortic Aneurysms (AAA) lead to?

    <p>Ischemia of kidneys, spinal cord, and GI tract</p> Signup and view all the answers

    Which of the following is a cause of inadequate/abnormal connective tissue synthesis, specifically with defective elastin and collagen synthesis?

    <p>Mutations in TGF-β</p> Signup and view all the answers

    Which type of collagen is defective in Ehlers-Danlos syndrome?

    <p>Type III</p> Signup and view all the answers

    Which enzyme degrades arterial connective tissue in the wall?

    <p>Protease</p> Signup and view all the answers

    Which of the following is a potential complication of Abdominal Aortic Aneurysms (AAA)?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a major risk factor for Thoracic Aortic Aneurysms?

    <p>All of the above</p> Signup and view all the answers

    What are the signs and symptoms of Thoracic Aortic Aneurysms?

    <p>All of the above</p> Signup and view all the answers

    Which age group is more likely to develop Aortic Dissection?

    <p>40-60 years with hypertension</p> Signup and view all the answers

    What is the morphology of Aortic Dissection?

    <p>Intimal tear leading to blood-filled channel within aortic wall</p> Signup and view all the answers

    Which artery may be compressed by blood dissecting upward from a tear with Aortic Dissection?

    <p>Right carotid artery</p> Signup and view all the answers

    What symptoms may patients with Aortic Dissection present with?

    <p>All of the above</p> Signup and view all the answers

    What can a massive amount of hemorrhage due to Aortic Dissection lead to?

    <p>Hemopericardium</p> Signup and view all the answers

    What is a potential complication of Aortic Dissection?

    <p>All of the above</p> Signup and view all the answers

    What are the clinical features of Aortic Dissection?

    <p>Sudden onset of excruciating, tearing pain, radiating to back between scapulae</p> Signup and view all the answers

    What is the effect of Aortic Dissection on the carotid artery?

    <p>Compression by blood dissecting upward from a tear</p> Signup and view all the answers

    Which layer of the artery is usually affected by Aortic Dissection?

    <p>Media</p> Signup and view all the answers

    What inhibits the propagation of dissecting hematoma in Aortic Dissection?

    <p>Fibrosis</p> Signup and view all the answers

    In the presence of substantial atherosclerosis or other causes of medial scarring, Aortic Dissection is...

    <p>Unusual</p> Signup and view all the answers

    Study Notes

    Myocardial Infarction

    • The highest incidence of myocardial infarction occurs in older age groups.
    • Premenopausal women are relatively protected against atherosclerosis compared to age-matched men.

    Atherosclerosis and Risk Factors

    • Factors predisposing premenopausal women to atherosclerosis include diabetes, obesity, and smoking.
    • The incidence of atherosclerosis-related diseases in women increases significantly post-menopause.
    • Estrogen replacement therapy may decrease cardiovascular risk in postmenopausal women.

    Atherosclerotic Lesions

    • Elevated LDL cholesterol alone is sufficient to induce atherosclerotic lesions in the absence of other risk factors.
    • LDL (low-density lipoprotein) is a major risk factor for atherosclerosis.
    • Older age groups, including men, have a higher incidence of atherosclerosis-related diseases.

    Lipids in Atherosclerosis

    • Dominant lipids found in plaques implicated in atherogenesis include cholesterol and triglycerides.
    • Lowering serum cholesterol can slow the progression of atherosclerosis and reduce plaque formation.

    Hypertension and Ischemic Heart Disease

    • Hypertension increases the risk of ischemic heart disease by approximately 60% compared to normotensive populations.
    • Prolonged cigarette smoking significantly raises the death rate from ischemic heart disease.
    • Diabetes induces hypercholesterolemia and markedly increases the risk of atherosclerosis.

    Response-to-Injury Hypothesis

    • The chronic inflammatory response of the arterial wall is triggered by various injurious stimuli.
    • Endothelial cell injury in atherosclerosis is characterized by increased permeability and leukocyte adhesion.

    Fatty Streaks and Atheromas

    • Fatty streaks are early lesions that may progress into mature atheromas under certain conditions.
    • Plaque inflammation leads to collagen degradation and reduced stability of atherosclerotic lesions.

    Aneurysms

    • A true aneurysm involves all layers of the artery, whereas a false (pseudoaneurysm) does not.
    • Aortic dissections occur due to a tear in the arterial wall, leading to the formation of a hematoma.

    Aortic Aneurysms

    • The thoracic aorta typically spares the coronary and renal arteries in aneurysmal disease.
    • Abdominal aortic aneurysms (AAA) frequently arise from atherosclerosis and are more common in men.

    Connective Tissue Disorders

    • Ehlers-Danlos syndrome involves defective synthesis of type III collagen, compromising vascular integrity.
    • Two major causes of endothelial cell injury are hypertension and hyperlipidemia.

    Aortic Dissection

    • Aortic dissection predominantly affects the intimal layer of the artery.
    • Symptoms may include severe, sudden chest or back pain, potentially leading to hemorrhagic complications.

    Clinical Recognition

    • Aortic dissection can compress nearby arteries, impacting blood flow and potentially leading to organ ischemia.
    • Early recognition of symptoms and prompt treatment are critical to preventing severe complications in aortic diseases.

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    Description

    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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