Atherosclerosis Pathophysiology Quiz
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Questions and Answers

What is the primary component of the adventitia?

  • Vascular smooth muscle cells
  • Lipid deposition
  • Connective tissue (correct)
  • Collagen and elastin fibers

    • What does 'athero' mean in Greek?

  • Narrowing
  • Smooth muscle proliferation
  • Gruel or paste (correct)
  • Hardening

    • What is the primary cause of vessel narrowing in arteriosclerosis?

  • Connective tissue
  • Smooth muscle proliferation (correct)
  • Collagen and elastin fibers
  • Lipid deposition

    • What is the source of VLDLs?

    <p>Excess proteins or carbs converted to triglycerides in the liver</p> Signup and view all the answers

    What allows the release of fatty acids from triglycerides in chylomicrons for uptake by muscle and adipose tissue?

    <p>Lipoprotein lipase (LPL)</p> Signup and view all the answers

    What is the primary component of the intima?

    <p>Abundant collagen and elastin fibers</p> Signup and view all the answers

    What is the most specific indicator for diagnosing myocardial infarction?

    <p>Elevation in cardiac troponin I</p> Signup and view all the answers

    What happens to myocytes during anaerobic metabolism in myocardial infarction?

    <p>Increased acidity inside the cell leads to cell death</p> Signup and view all the answers

    What does the zone of infarction in myocardial infarction contain?

    <p>Dead cardiac myocytes</p> Signup and view all the answers

    What replaces necrotic tissue at the site of infarction in myocardial infarction?

    <p>Fibrotic scar tissue</p> Signup and view all the answers

    What occurs after myocardial infarction that leads to scar tissue synthesis?

    <p>Robust inflammatory response</p> Signup and view all the answers

    What is the mortality rate associated with myocardial infarction?

    <p>30%</p> Signup and view all the answers

    What is the most damaging type of myocardial infarction that can be detected by ECG?

    <p>ST elevation (STEMI)</p> Signup and view all the answers

    What is the most common cause of CAD?

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

    What percentage of cardiovascular disease risk is attributed to modifiable factors according to the INTERHEART study?

    <p>Over 90%</p> Signup and view all the answers

    What is the alternative to pharmacotherapy that is emerging in the context of preventive medicine?

    <p>Lifestyle changes</p> Signup and view all the answers

    What is the characteristic symptom of stable angina pectoris?

    <p>Chest pain associated with reversible myocardial ischemia</p> Signup and view all the answers

    Which classification of myocardial infarction (MI) is more serious?

    <p>ST elevation MI (STEMI)</p> Signup and view all the answers

    What is the common cause of myocardial infarction (MI)?

    <p>Rupture of atherosclerotic plaques</p> Signup and view all the answers

    What is the role of LPL on capillary walls in atherosclerosis?

    <p>It allows uptake of fatty acids from TGs in VLDL by muscle and adipose tissue</p> Signup and view all the answers

    What is the function of HDL in atherosclerosis?

    <p>Participates in reverse cholesterol transport, taking excess cholesterol back to the liver</p> Signup and view all the answers

    What characterizes a fatty streak, an early atherosclerotic lesion?

    <p>LDL accumulation and foam cells</p> Signup and view all the answers

    How does endothelial dysfunction contribute to atherosclerotic lesion development?

    <p>It leads to increased vascular permeability, LDL deposition, and oxidative stress</p> Signup and view all the answers

    What is the significance of LDL oxidation in atherosclerosis?

    <p>It influences atherosclerosis risk by affecting LDL levels and oxidation</p> Signup and view all the answers

    What are the complications of atherosclerosis mentioned in the text?

    <p>Peripheral artery disease (PAD) with symptoms such as intermittent claudication</p> Signup and view all the answers

    What is the leading cause of hospitalization in Americans over 65?

    <p>Ischemic heart disease</p> Signup and view all the answers

    What is the eight-year survival rate for heart failure in Americans over 65?

    <p>15%</p> Signup and view all the answers

    What is the primary factor contributing to ventricular stretching in heart failure?

    <p>Increased afterload</p> Signup and view all the answers

    What effect does fibrosis have on the ventricle in heart failure?

    <p>Promotes ventricular dilation</p> Signup and view all the answers

    What is the end result of an increase in afterload in heart failure?

    <p>Decrease in cardiac output</p> Signup and view all the answers

    What is the primary cause of increased afterload in left heart failure?

    <p>Increased renin and angiotensin levels</p> Signup and view all the answers

    Which condition is a common secondary cause of right heart failure?

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

    What is the result of increased pulmonary resistance in right heart failure?

    <p>Dilation of the right ventricle</p> Signup and view all the answers

    What is the primary benefit of sacubitril valsartan (Entresto) for heart failure?

    <p>Inhibits neprilysin and blocks the RAAS pathway</p> Signup and view all the answers

    What is the mechanism of action of evolocumab (Repatha) in treating high cholesterol levels?

    <p>Binds to PCSK9 to prevent LDL receptor degradation</p> Signup and view all the answers

    What was the adherence rate to plant-based nutrition among the 198 patients with established cardiovascular disease (CVD) in the study?

    <p>89%</p> Signup and view all the answers

    How many major cardiac events were experienced by adherent cardiovascular participants in the study?

    <p>One stroke</p> Signup and view all the answers

    What percentage of nonadherent participants in the study experienced adverse events?

    <p>62%</p> Signup and view all the answers

    Which factor showed the greatest improvement contrary to expectations in the regression of coronary atherosclerosis?

    <p>Severity of stenosed lesions</p> Signup and view all the answers

    What did the study suggest about the regression of coronary atherosclerosis?

    <p>It requires substantial lifestyle changes to halt or reverse</p> Signup and view all the answers

    What was the effect observed on the progression and regression of atherosclerosis based on gender?

    <p>Gender may affect the progression and regression</p> Signup and view all the answers

    Study Notes

    Atherosclerosis and Its Pathophysiology

    • LPL on capillary walls allows uptake of fatty acids from TGs in VLDL by muscle and adipose tissue
    • TGs removed from VLDL can become intermediate density lipoprotein or low density lipoprotein (LDL)
    • Cholesterol delivery system for cells is receptor-mediated
    • HDL participates in reverse cholesterol transport, taking excess cholesterol back to the liver
    • Hyperhomocysteinemia is related to diet and B vitamin deficiency, increasing cardiovascular disease risk
    • Atherosclerosis progression: inflammation of endothelium, LDL uptake, macrophage migration, foam cell formation, cellular proliferation, fibrous plaque, complicated plaque
    • Endothelial dysfunction initiates atherosclerotic lesion development, leading to increased vascular permeability, LDL deposition, and oxidative stress
    • Endothelial dysfunction results in decreased nitric oxide production, inhibiting platelet activation and vascular smooth muscle cell proliferation
    • Fatty streak is an early atherosclerotic lesion characterized by LDL accumulation and foam cells
    • Fibrous plaque is a visible atherosclerotic lesion characterized by smooth muscle cell accumulation and extracellular matrix
    • Complicated plaque is a ruptured atherosclerotic lesion that initiates thrombus formation
    • Importance of LDL oxidation: dietary factors, smoking, diabetes, hypertension, monounsaturated fatty acids, and omega-3 fatty acids affect LDL levels and oxidation, influencing atherosclerosis risk
    • Complications of atherosclerosis include peripheral artery disease (PAD) with symptoms such as intermittent claudication, especially prevalent in smokers and those with diabetes

    Regression of Coronary Atherosclerosis

    • Small lifestyle changes may slow atherosclerosis progression, while substantial changes may be needed to halt or reverse it
    • 5 women in the study showed regression with only moderate lifestyle changes, all were postmenopausal and not taking exogenous estrogens
    • Gender may affect the progression and regression of atherosclerosis
    • 4 women in the control group showed more regression than any men, despite some men making greater lifestyle changes
    • 5 men in the control group showed very slight regression, exercised more, consumed fewer calories and less cholesterol
    • Severely stenosed lesions showed the greatest improvement, contrary to expectations
    • Evidence suggests that diet, exercise, stress, and smoking play roles in coronary heart disease
    • Only two other randomized, controlled trials have shown regression of coronary atherosclerosis
    • Comprehensive lifestyle changes may begin to reverse coronary atherosclerosis in only a year
    • The study was supported by grants from various organizations
    • Investigators involved in the trial include administrators, counselors, stress management instructors, exercise instructors, chefs, angiography analysts, nurses, angiographers, radiologists, and others
    • References include presentations and studies on regression of atherosclerosis, effects of vegetarian diet and yoga, stress management training, identifying and measuring coronary artery stenosis, blood cholesterol measurement, and apoprotein composition of lipoproteins

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    Description

    Test your knowledge of atherosclerosis and its pathophysiology with this quiz. Explore the progression of atherosclerosis, the role of lipoproteins, endothelial dysfunction, and the complications associated with this cardiovascular disease.

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