Ch 11 pp 493-504
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Questions and Answers

What is the main cause of morbidity and mortality in the Western world?

  • Obesity
  • Atherosclerosis (correct)
  • Diabetes
  • Hypertension
  • Which manifestation of atherosclerosis is responsible for almost a quarter of all deaths in the United States?

  • Carotid atherosclerotic disease
  • Myocardial infarction (correct)
  • Aortic atherosclerotic disease
  • Stroke
  • What are the main components of an atheromatous plaque?

  • Fibrous core and lipid cap
  • Calcium deposits and fibrous cap
  • Fibrous core and calcium cap
  • Lipid core and fibrous cap (correct)
  • What determines the likelihood of atherosclerosis?

    <p>Acquired and inherited risk factors</p> Signup and view all the answers

    What can atherosclerotic plaques lead to, besides mechanically obstructing blood flow?

    <p>Catastrophic obstructive vascular thrombosis</p> Signup and view all the answers

    What is the most important manifestation of atherosclerosis mentioned in the text?

    <p>Coronary artery disease</p> Signup and view all the answers

    Which factor is associated with coronary atherosclerosis, peripheral vascular disease, stroke, and venous thrombosis?

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

    What is a strong, independent marker of risk for cardiovascular events?

    <p>C-reactive protein (CRP)</p> Signup and view all the answers

    Which factor is a potent predictor of major atherosclerotic events, including myocardial infarction and stroke?

    <p>Markers of hemostatic and fibrinolytic function</p> Signup and view all the answers

    What is characterized by central obesity, insulin resistance, hypertension, dyslipidemia, hypercoagulability, and proinflammatory state?

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

    What is viewed as a chronic inflammatory and healing response of the arterial wall to endothelial injury?

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

    What is the most common cause of left ventricular hypertrophy and a surrogate marker for cardiovascular risk?

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

    Which factor is strongly associated with atherosclerosis due to certain Mendelian disorders?

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

    What is the dominant influence for the incidence of myocardial infarction?

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

    Which class of drugs is widely used to lower serum cholesterol levels and lower rates of myocardial infarctions?

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

    What can increase the risk of ischemic heart disease by approximately 60% versus normotensive populations?

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

    Which population has death rates for coronary artery disease exceeding those in the United States?

    <p>Eastern European countries</p> Signup and view all the answers

    What is relatively protective against atherosclerosis and its consequences compared with age-matched men?

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

    What are the dominant lipids in atheromatous plaques?

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

    What directly impairs endothelial function and leads to the formation of foam cells?

    <p>Chronic hyperlipidemia, particularly hypercholesterolemia</p> Signup and view all the answers

    What contributes to the progressive growth of atherosclerotic lesions?

    <p>Intimal smooth muscle cell proliferation and extracellular matrix deposition</p> Signup and view all the answers

    What is the result of lipoprotein abnormalities associated with increased risk of atherosclerosis?

    <p>Increased LDL cholesterol levels and decreased HDL cholesterol levels</p> Signup and view all the answers

    What promotes atheroprotective gene expression?

    <p>Laminar flow</p> Signup and view all the answers

    What plays critical roles in the pathogenesis of atherosclerosis?

    <p>Inflammation, oxidative stress, and lipid accumulation</p> Signup and view all the answers

    What stimulates smooth muscle cells to synthesize extracellular matrix, stabilizing atherosclerotic plaques?

    <p>Platelet-derived growth factor (PDGF)</p> Signup and view all the answers

    What is the major consequence of a growing atherosclerotic plaque?

    <p>Compromised blood flow, erosion, or rupture</p> Signup and view all the answers

    What leads to platelet and monocyte adhesion due to endothelial dysfunction?

    <p>Hyperlipidemia, hyperglycemia, and hypertension</p> Signup and view all the answers

    What do foam cells in atheromatous plaques accumulate from macrophages and smooth muscle cells?

    <p>Modified lipids</p> Signup and view all the answers

    Which vessels are primarily affected by atherosclerosis?

    <p>Large elastic and muscular arteries</p> Signup and view all the answers

    When does critical stenosis occur?

    <p>When the occlusion produces a 70% to 75% decrease in luminal cross-sectional area</p> Signup and view all the answers

    Study Notes

    Atherosclerosis: Pathogenesis and Consequences

    • Growth factors like PDGF, FGF, and TGF-α stimulate SMCs to synthesize ECM, stabilizing atherosclerotic plaques.
    • Atherosclerosis is a chronic inflammatory response driven by EC injury, lipid accumulation, and inflammation.
    • Atheromas consist of dysfunctional ECs, proliferating SMCs, T lymphocytes, and macrophages, releasing mediators influencing atherogenesis.
    • Plaques evolve from aggregates of SMCs, macrophages, and foam cells to lesions with ECM, fibrous caps, and central lipid cores.
    • A growing atherosclerotic plaque compromises blood flow, erodes, or ruptures, leading to thrombosis and vascular occlusion.
    • Endothelial dysfunction due to hyperlipidemia, hyperglycemia, and hypertension results in platelet and monocyte adhesion.
    • Foam cells in atheromatous plaques accumulate modified lipids from macrophages and SMCs, leading to cholesterol accumulation.
    • Consequences of atherosclerosis include myocardial infarction, stroke, aortic aneurysms, and peripheral vascular disease.
    • Large elastic and muscular arteries are major targets of atherosclerosis, primarily affecting the heart, brain, kidneys, and lower extremities.
    • Atherosclerotic stenosis gradually occludes vessel lumens, compromising blood flow and causing ischemic injury.
    • Critical stenosis occurs when the occlusion produces a 70% to 75% decrease in luminal cross-sectional area, leading to tissue ischemia.
    • Acute plaque change, such as erosion or rupture, results in vascular thrombosis and acute tissue infarction.

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    Test your knowledge of atherosclerosis pathogenesis and its consequences with this quiz. Explore the role of growth factors, inflammatory responses, plaque development, endothelial dysfunction, and the impact on various organs. Understand the link between atherosclerosis and conditions like myocardial infarction, stroke, and peripheral vascular disease.

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