30 Questions
What is the main cause of morbidity and mortality in the Western world?
Atherosclerosis
Which manifestation of atherosclerosis is responsible for almost a quarter of all deaths in the United States?
Myocardial infarction
What are the main components of an atheromatous plaque?
Lipid core and fibrous cap
What determines the likelihood of atherosclerosis?
Acquired and inherited risk factors
What can atherosclerotic plaques lead to, besides mechanically obstructing blood flow?
Catastrophic obstructive vascular thrombosis
What is the most important manifestation of atherosclerosis mentioned in the text?
Coronary artery disease
Which factor is associated with coronary atherosclerosis, peripheral vascular disease, stroke, and venous thrombosis?
Hyperhomocysteinemia
What is a strong, independent marker of risk for cardiovascular events?
C-reactive protein (CRP)
Which factor is a potent predictor of major atherosclerotic events, including myocardial infarction and stroke?
Markers of hemostatic and fibrinolytic function
What is characterized by central obesity, insulin resistance, hypertension, dyslipidemia, hypercoagulability, and proinflammatory state?
Metabolic syndrome
What is viewed as a chronic inflammatory and healing response of the arterial wall to endothelial injury?
Atherosclerosis
What is the most common cause of left ventricular hypertrophy and a surrogate marker for cardiovascular risk?
Chronic hypertension
Which factor is strongly associated with atherosclerosis due to certain Mendelian disorders?
Hyperlipidemia
What is the dominant influence for the incidence of myocardial infarction?
Age
Which class of drugs is widely used to lower serum cholesterol levels and lower rates of myocardial infarctions?
Statins
What can increase the risk of ischemic heart disease by approximately 60% versus normotensive populations?
Hypertension
Which population has death rates for coronary artery disease exceeding those in the United States?
Eastern European countries
What is relatively protective against atherosclerosis and its consequences compared with age-matched men?
Premenopausal women
What are the dominant lipids in atheromatous plaques?
Cholesterol and cholesterol esters
What directly impairs endothelial function and leads to the formation of foam cells?
Chronic hyperlipidemia, particularly hypercholesterolemia
What contributes to the progressive growth of atherosclerotic lesions?
Intimal smooth muscle cell proliferation and extracellular matrix deposition
What is the result of lipoprotein abnormalities associated with increased risk of atherosclerosis?
Increased LDL cholesterol levels and decreased HDL cholesterol levels
What promotes atheroprotective gene expression?
Laminar flow
What plays critical roles in the pathogenesis of atherosclerosis?
Inflammation, oxidative stress, and lipid accumulation
What stimulates smooth muscle cells to synthesize extracellular matrix, stabilizing atherosclerotic plaques?
Platelet-derived growth factor (PDGF)
What is the major consequence of a growing atherosclerotic plaque?
Compromised blood flow, erosion, or rupture
What leads to platelet and monocyte adhesion due to endothelial dysfunction?
Hyperlipidemia, hyperglycemia, and hypertension
What do foam cells in atheromatous plaques accumulate from macrophages and smooth muscle cells?
Modified lipids
Which vessels are primarily affected by atherosclerosis?
Large elastic and muscular arteries
When does critical stenosis occur?
When the occlusion produces a 70% to 75% decrease in luminal cross-sectional area
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.
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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