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Questions and Answers
Which factor is primarily responsible for increasing preload in left-sided heart failure?
Which factor is primarily responsible for increasing preload in left-sided heart failure?
What role does increased afterload play in heart failure?
What role does increased afterload play in heart failure?
What is a common consequence of untreated Deep Vein Thrombosis (DVT)?
What is a common consequence of untreated Deep Vein Thrombosis (DVT)?
Which type of heart failure develops as a direct result of left-sided heart failure?
Which type of heart failure develops as a direct result of left-sided heart failure?
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What distinguishes systolic heart failure from diastolic heart failure?
What distinguishes systolic heart failure from diastolic heart failure?
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What condition is primarily indicated by pain, cramping, or fatigue in the legs during activity, relieved by rest?
What condition is primarily indicated by pain, cramping, or fatigue in the legs during activity, relieved by rest?
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Which of the following factors does NOT contribute to the triad of Virchow related to venous thrombosis?
Which of the following factors does NOT contribute to the triad of Virchow related to venous thrombosis?
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What symptom is commonly associated with peripheral artery disease as a result of poor blood flow?
What symptom is commonly associated with peripheral artery disease as a result of poor blood flow?
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Which statement regarding deep vein thrombosis (DVT) is true?
Which statement regarding deep vein thrombosis (DVT) is true?
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What lifestyle factor is a primary risk factor for the development of peripheral artery disease (PAD)?
What lifestyle factor is a primary risk factor for the development of peripheral artery disease (PAD)?
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What physiological change contributes to venous stasis specifically in heart failure?
What physiological change contributes to venous stasis specifically in heart failure?
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Which condition is characterized by sores or wounds on the feet or legs that heal slowly?
Which condition is characterized by sores or wounds on the feet or legs that heal slowly?
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Which of the following best describes hypercoagulable states?
Which of the following best describes hypercoagulable states?
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What initiates the development of atherosclerotic plaques?
What initiates the development of atherosclerotic plaques?
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Which cytokine is released by macrophages that contributes to inflammation in atherosclerosis?
Which cytokine is released by macrophages that contributes to inflammation in atherosclerosis?
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Which of the following is considered a traditional risk factor for endothelial injury leading to atherosclerosis?
Which of the following is considered a traditional risk factor for endothelial injury leading to atherosclerosis?
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What is formed when macrophages engulf oxidized LDL?
What is formed when macrophages engulf oxidized LDL?
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What role do oxidized LDL and foam cells play in atherosclerosis?
What role do oxidized LDL and foam cells play in atherosclerosis?
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Which process leads to the formation of fibrous plaques in atherosclerosis?
Which process leads to the formation of fibrous plaques in atherosclerosis?
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Which condition is primarily caused by the progression of atherosclerosis?
Which condition is primarily caused by the progression of atherosclerosis?
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In addition to endothelial injury, which of the following can be considered a nontraditional risk factor for atherosclerosis?
In addition to endothelial injury, which of the following can be considered a nontraditional risk factor for atherosclerosis?
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What characterizes the fatty streak in atherosclerosis?
What characterizes the fatty streak in atherosclerosis?
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How does inflammation within the arterial wall contribute to atherosclerosis?
How does inflammation within the arterial wall contribute to atherosclerosis?
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What is the primary pathological process involved in atherosclerosis?
What is the primary pathological process involved in atherosclerosis?
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Which of the following is NOT a typical symptom of Peripheral Artery Disease (PAD)?
Which of the following is NOT a typical symptom of Peripheral Artery Disease (PAD)?
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Which treatment option is commonly used for severe cases of PAD?
Which treatment option is commonly used for severe cases of PAD?
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How does angiotensin II contribute to hypertension?
How does angiotensin II contribute to hypertension?
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What is a significant risk associated with unstable angina?
What is a significant risk associated with unstable angina?
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Which of the following correctly describes stable angina?
Which of the following correctly describes stable angina?
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Which condition can be directly caused by atherosclerosis?
Which condition can be directly caused by atherosclerosis?
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What are vasodilators primarily used for in relation to PAD?
What are vasodilators primarily used for in relation to PAD?
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What is the main factor contributing to the development of atherosclerosis?
What is the main factor contributing to the development of atherosclerosis?
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Which is a potential trigger for vasospastic angina?
Which is a potential trigger for vasospastic angina?
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Which mechanism primarily contributes to renal dysfunction in hypertension?
Which mechanism primarily contributes to renal dysfunction in hypertension?
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What is an essential characteristic of diastolic heart failure?
What is an essential characteristic of diastolic heart failure?
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Which of the following is NOT a potential cause of varicose veins?
Which of the following is NOT a potential cause of varicose veins?
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Which of the following diagnostic tools is most likely used to evaluate Superior Vena Cava Syndrome?
Which of the following diagnostic tools is most likely used to evaluate Superior Vena Cava Syndrome?
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The renin-angiotensin-aldosterone system (RAAS) is primarily involved in which of the following functions?
The renin-angiotensin-aldosterone system (RAAS) is primarily involved in which of the following functions?
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What symptom is NOT commonly associated with Superior Vena Cava Syndrome?
What symptom is NOT commonly associated with Superior Vena Cava Syndrome?
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In the context of hypertension, what effect does sustained systemic vasoconstriction have?
In the context of hypertension, what effect does sustained systemic vasoconstriction have?
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Which of the following is a primary factor contributing to the development of diastolic heart failure?
Which of the following is a primary factor contributing to the development of diastolic heart failure?
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Which of the following factors does NOT contribute to hypertension development?
Which of the following factors does NOT contribute to hypertension development?
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What is the primary treatment strategy for non-malignant causes of Superior Vena Cava Syndrome?
What is the primary treatment strategy for non-malignant causes of Superior Vena Cava Syndrome?
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Study Notes
Atherosclerosis
- Atherosclerosis is an inflammatory disease of blood vessels, causing thickening and hardening of the vessel walls.
- It involves the accumulation of lipid-laden macrophages, forming plaques in the arteries.
- This process can affect vascular systems throughout the body, leading to peripheral artery disease, coronary artery disease, and cerebrovascular disease.
- Plaque development begins with endothelial injury caused by risk factors like smoking, hypertension, diabetes, high LDL, low HDL, and autoimmunity.
- Inflammation and expression of adhesion molecules contribute to macrophage recruitment and further vascular damage.
- Oxidized LDL attracts monocytes to form foam cells and fatty streaks, which contribute to plaque growth and vessel wall damage.
- Fibrous plaques develop as smooth muscle cells proliferate and produce collagen, and migrate across fatty streaks creating a fibrous cap.
- Plaque rupture exposes underlying tissue, stimulating platelet adhesion, clotting cascade, and thrombus formation, possibly leading to ischemia and infarction.
Cellular Injury and Death during Ischemia and Oxidative Stress
- Ischemia: Insufficient blood supply to tissues, depriving cells of oxygen and nutrients.
- Oxidative Stress: Imbalance between reactive oxygen species (ROS) production and the body's ability to detoxify or repair damage from ROS.
- Mechanisms of Cellular Injury: ATP depletion, calcium overload, free radical formation, inflammation.
- Necrosis: Passive cell death due to acute injury, characterized by cell swelling, membrane rupture, and release of cellular contents, triggering inflammation.
- Apoptosis: Active, programmed cell death, initiated by specific signals, characterized by cell shrinkage, DNA fragmentation, and formation of apoptotic bodies (without inflammation).
Myocardial Infarction (MI)
- MI, or heart attack, is caused by sudden blockage of blood flow to the heart muscle.
- Blockages are usually caused by a blood clot formed in a coronary artery.
- Pathophysiology involves plaque rupture, thrombus formation, and prolonged ischemia leading to cellular death (apoptosis) and tissue necrosis.
- Extent of damage depends on location, size of blockage, and restoration time.
- Clinical manifestations can vary, including chest pain, shortness of breath, sweating, nausea, vomiting, lightheadedness, and anxiety.
Thrombus vs Embolus
- Thrombus: A blood clot formed within a blood vessel that obstructs blood flow.
- Embolus: Any substance traveling in the bloodstream that obstructs blood flow when reaching a vessel too small to pass through. Examples include blood clot, air bubble or foreign material.
Hypertension
- Hypertension is persistently elevated systemic arterial blood pressure.
- Risk factors include positive family history, male sex, advancing age, black race, obesity, high sodium intake, low magnesium/potassium/calcium, diabetes, smoking, and heavy alcohol consumption.
- Pathophysiological mechanisms include increased activity of the sympathetic nervous system, overactive renin-angiotensin-aldosterone system (RAAS), sodium and water retention by kidneys, defects in renal sodium excretion, and insulin resistance.
Endothelial Dysfunction
- Endothelial cells line blood vessels and play a role in regulating blood flow.
- Dysfunction impairs the production of vasodilators and promotes vasoconstriction.
- Inflammation contributes to the development and progression of hypertension and endothelial dysfunction.
Congenital Heart Diseases (Tricuspid Atresia)
- Tricuspid atresia is a congenital heart defect wherein the tricuspid valve is missing or abnormally developed.
- Resultant pathophysiology involves lack of communication between the right atrium and right ventricle, leading to blood flow through an ASD or PFO to the left side, and to the lungs.
- Blood mixing on the left side causes hypoxemia and mild cyanosis.
Tetralogy of Fallot
- Tetralogy of Fallot is a congenital heart defect characterized by 4 specific defects.
- Ventricular septal defect (VSD): hole in the wall separating ventricles
- Pulmonary stenosis: narrowing of the pulmonary valve, controlling blood flow from the right ventricle to the lungs
- Overriding aorta: Aorta shifted slightly to the right over the VSD
- Right ventricular hypertrophy.
Patent Ductus Arteriosus (PDA)
- PDA is a condition where the ductus arteriosus (connection between aorta and pulmonary artery in a fetus) fails to close after birth.
- Pathophysiology involves blood flow from the aorta (higher pressure) to the pulmonary artery, increasing blood flow to the lungs, potentially leading to heart failure if untreated.
Ventricular Septal Defect (VSD)
- VSD is a congenital heart defect characterized by a hole in the wall (septum) separating the ventricles of the heart.
- Pathophysiology involves blood flow from the left ventricle (higher pressure) to the right ventricle, increasing blood flow to the lungs.
Peripheral Artery Disease (PAD)
- PAD is a circulatory problem where narrowed arteries reduce blood flow to the limbs, primarily caused by atherosclerosis (plaque buildup in the arteries).
- Risk factors include smoking, diabetes, high blood pressure, high cholesterol, and family history.
- Clinical manifestations include intermittent claudication (pain during activity relieved by rest).
Deep Venous Thrombosis (DVT)
- DVT is a blood clot formation in a deep vein, typically in the legs.
- Three factors (Virchow's triad) promote DVT: venous stasis, endothelial damage, and hypercoagulability.
- Potential symptoms include pain, swelling, redness in affected areas. Can lead to potentially serious thromboembolizations if not treated.
Left and Right Sided Heart Failure
- Left-sided heart failure: Left ventricle struggles to pump blood effectively to the body.
- Right-sided heart failure: Right ventricle struggles to pump blood effectively to the lungs.
- Pathophysiology of both involves reduced cardiac output, increased workload for the affected side, and pressure differences throughout the heart.
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Description
This quiz covers the key aspects of atherosclerosis, an inflammatory disease that affects blood vessels by causing thickening and hardening. It details the mechanisms behind plaque formation and the risk factors that contribute to this vascular condition. Understanding the pathology of atherosclerosis is crucial for recognizing its implications in various cardiovascular diseases.
