Cardiovascular Disease: Coronary Obstruction and Lipoproteins
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Questions and Answers

What is the primary function of fatty acids in the body?

  • Building cell membranes
  • Producing steroid hormones
  • Serving as an energy source for skeletal and heart muscle (correct)
  • Forming bile

    • What is the result of LDL particles becoming small enough to enter the endothelial wall?

  • Vasculitis is triggered
  • HDL particles are formed
  • Excessive cholesterol is removed from tissues
  • Atherosclerosis occurs (correct)

    • Which of the following is a cause of coronary obstruction?

  • Vasodilation of coronary arteries
  • Idiopathic vasospasm of coronary arteries (correct)
  • Increased production of HDL
  • Atherosclerosis of peripheral arteries

    • What is the primary function of HDL particles?

    <p>Picking up excessive cholesterol from tissues and bringing it back to the liver</p> Signup and view all the answers

    What is the result of the liver repackaging chylomicrons into VLDL?

    <p>VLDL uploads triglycerides and fatty acids to tissues</p> Signup and view all the answers

    What is the primary reason why lipids are transported in lipoprotein particles?

    <p>Lipids are hydrophobic</p> Signup and view all the answers

    What is the primary goal of using beta blockers in treating Acute Coronary Syndrome?

    <p>To decrease heart rate and prolong diastole</p> Signup and view all the answers

    What is the main difference between Unstable Angina and Acute Myocardial Infarction?

    <p>Degree of thrombosis</p> Signup and view all the answers

    What is the primary mechanism of ischemia in Acute Coronary Syndrome?

    <p>Disruption of blood supply due to thrombosis</p> Signup and view all the answers

    What is the most common early complication of Acute Myocardial Infarction?

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

    What is the primary mechanism of necrosis in Acute Myocardial Infarction?

    <p>Accumulation of lactate leading to calcium influx into cells</p> Signup and view all the answers

    What is the primary role of macrophages in the healing process of Acute Myocardial Infarction?

    <p>Phagocytosing necrotic cells</p> Signup and view all the answers

    What is the typical time frame for necrosis to complete in Acute Myocardial Infarction?

    <p>Within 6-12 hours</p> Signup and view all the answers

    What is the late complication of Acute Myocardial Infarction that reflects inflammation and healing of necrotic tissues?

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

    What is the primary cause of atherosclerosis?

    <p>Familial dyslipidemia</p> Signup and view all the answers

    What is the result of glucose binding to blood lipids and proteins in diabetes?

    <p>Formation of advanced glycation end products</p> Signup and view all the answers

    What is the effect of high blood pressure on endothelial cells?

    <p>Vasoconstriction and increased endothelial permeability</p> Signup and view all the answers

    What is the characteristic of an unstable atherosclerotic plaque?

    <p>Thin fibrotic cap</p> Signup and view all the answers

    What is the result of the rupture of an atherosclerotic plaque?

    <p>Formation of a thrombus</p> Signup and view all the answers

    What is the characteristic of stable ischemic heart disease?

    <p>Reversible ischemia with a predictable pattern of pain</p> Signup and view all the answers

    What is the diagnosis of stable ischemic heart disease?

    <p>ST depression during stress test</p> Signup and view all the answers

    What is the effect of high fat diet on lipoprotein metabolism?

    <p>Increased VLDL production</p> Signup and view all the answers

    What is the result of oxidative stress on endothelial cells?

    <p>Damage to endothelial cells</p> Signup and view all the answers

    What is the characteristic of complicated atherosclerotic plaques?

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

    What is the primary role of cholesterol in the body?

    <p>Component of cell membranes, steroid hormones, and bile</p> Signup and view all the answers

    What is the purpose of lipoprotein particles in the body?

    <p>To transport lipids in the blood</p> Signup and view all the answers

    What is the result of the liver repackaging VLDL into LDL?

    <p>The LDL particles become smaller and more dense</p> Signup and view all the answers

    What is the primary function of triglycerides in the body?

    <p>Energy source for skeletal and heart muscle</p> Signup and view all the answers

    What is the result of the accumulation of LDL particles in the endothelial wall?

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

    What is the primary function of HDL particles in the body?

    <p>To pick up excessive cholesterol from tissues and bring it back to the liver</p> Signup and view all the answers

    What is the primary goal of aspirin therapy in Acute Coronary Syndrome?

    <p>To reduce platelet aggregation</p> Signup and view all the answers

    What is the primary mechanism of ischemia in Unstable Angina?

    <p>Supply ischemia</p> Signup and view all the answers

    What is the characteristic of an Acute Myocardial Infarction?

    <p>100% thrombosis</p> Signup and view all the answers

    What is the typical ECG finding in Non-ST elevation MI?

    <p>ST depression</p> Signup and view all the answers

    What is the primary role of beta blockers in treating Acute Coronary Syndrome?

    <p>To decrease heart rate</p> Signup and view all the answers

    What is the primary mechanism of necrosis in Acute Myocardial Infarction?

    <p>Oxygen deprivation</p> Signup and view all the answers

    What is the late complication of Acute Myocardial Infarction that reflects inflammation and healing of necrotic tissues?

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

    What is the primary mechanism of cardiac remodeling in Acute Myocardial Infarction?

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

    What is the primary cause of increased LDL particles in the bloodstream in individuals with familial dyslipidemia?

    <p>Defect in LDL receptors</p> Signup and view all the answers

    Which of the following is a risk factor for atherosclerosis that leads to the formation of Advanced Glycation End products (AGEs)?

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

    What is the primary mechanism by which high blood pressure contributes to atherosclerosis?

    <p>Decreased nitric oxide production by endothelial cells</p> Signup and view all the answers

    Which type of atherosclerotic plaque is characterized by a thin fibrotic cap and a large lipid core?

    <p>Unstable plaque</p> Signup and view all the answers

    What is the primary mechanism by which platelets contribute to the formation of atherosclerotic plaque?

    <p>Release of growth factors</p> Signup and view all the answers

    What is the primary symptom of stable ischemic heart disease?

    <p>Chest pain with activity, relieved with rest</p> Signup and view all the answers

    Which of the following is a characteristic of uncomplicated atherosclerotic plaques?

    <p>Slowly growing, asymptomatic</p> Signup and view all the answers

    What is the primary mechanism by which oxidized LDL contributes to the formation of atherosclerotic plaque?

    <p>_activation of macrophages</p> Signup and view all the answers

    Which of the following is a risk factor for atherosclerosis that leads to the formation of reactive oxygen species?

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

    What is the primary mechanism by which high intake of refined carbohydrates and sugars contributes to dyslipidemia?

    <p>Increased production of VLDL</p> Signup and view all the answers

    Study Notes

    Causes of Coronary Obstruction

    • Atherosclerotic narrowing of coronary arteries
    • Drug-induced coronary vasospasm (e.g., cocaine)
    • Idiopathic vasospasm of coronary arteries (Prinzmetal angina)
    • Inflammation of coronary arteries (e.g., vasculitis, Kawasaki disease)

    Lipoproteins

    • Lipids: cholesterol, free fatty acids, triglycerides
    • Lipids are essential for life
    • Fatty acids: energy source for skeletal and heart muscle
    • Cholesterol: builds cell membranes, steroid hormones, and bile
    • Lipids are hydrophobic, travel in blood inside lipoprotein particles

    Metabolism of Lipoproteins

    • Eating: fatty acids digested in intestinal wall, packaged in chylomicrons
    • Liver: repackages into VLDL, travels around, uploads TG and fatty acids to tissue
    • VLDL converted to LDL, circulates, eventually empties out, and returns to liver
    • Liver clears LDL from circulation, recycles it

    Atherosclerosis

    • Building of atherosclerotic plaque in artery walls, narrowing the lumen
    • Affects coronary, popliteal, carotid, and renal arteries
    • Begins in childhood, develops slowly
    • Most common causes of dyslipidemia: familial, high fat diet, high intake of refined carbs and sugars, obesity, and diabetes

    Risk Factors of Atherosclerosis and Mechanism

    • Smoking: production of reactive oxygen species, oxidative stress, damage to endothelial cells
    • Diabetes: glucose binds to blood lipids and proteins, forming AGEs, damaging endothelial cells
    • HTN: shear mechanical stress on endothelial cells, decrease in nitric oxide, vasoconstriction, and increased endothelial permeability
    • Dyslipidemia (elevated LDL): increased LDL in blood, accumulation of lipoprotein in subendothelial space

    Formation of Atherosclerotic Plaque

    • Excessive LDL deposited in endothelium, oxidized inside, producing soft lipid-loaded core
    • Platelets stick to endothelial cells, release growth factors, forming hard fibrotic cap
    • Types of atherosclerotic plaques: uncomplicated, complicated, and unstable plaques

    Unstable Plaques and Rupture

    • Oxidized LDL attracts macrophages, secreting lytic enzymes, degrading collagen of cap, leading to rupture
    • Rupture of cap: activation of platelets and clotting cascade, formation of thrombus, and ischemia

    Ischemic Heart Disease Syndromes

    • Stable ischemic heart disease (due to uncomplicated stable plaque)
    • Acute coronary syndrome (due to complicated unstable plaque)
    • Unstable angina (reversible ischemia)
    • Acute myocardial infarction (irreversible infarction)

    Stable Ischemic Heart Disease

    • Chest pain, pressure, tightness with activity, relieved with rest
    • Due to narrowing of coronary artery by stable slowly growing atherosclerotic plaque
    • When demand increases, ischemia results (demand ischemia)
    • Reversible when demand decreases (rest)
    • Subendocardial area more prone to ischemia than epicardial

    Acute Coronary Syndrome

    • Unstable angina: acute onset of chest pain/pressure at rest or unrelieved by rest
    • Due to rupture of atherosclerotic plaque with thrombosis
    • Ischemia not related to demand (supply ischemia)
    • Reversible ischemia if thrombus is broken down
    • Infarction if thrombus keeps growing

    Acute Myocardial Infarction

    • Acute onset of chest pain/pressure at rest or unrelieved by rest
    • Due to rupture of atherosclerotic plaque with 100% thrombosis
    • Main artery occlusion > transmural infarct
    • Distal branch occlusion > subendocardial infarct
    • Arterial thrombosis produces MI (necrosis, irreversible damage), not related to demand

    Causes of Coronary Obstruction

    • Atherosclerotic narrowing of coronary arteries
    • Drug-induced coronary vasospasm (e.g., cocaine)
    • Idiopathic vasospasm of coronary arteries (Prinzmetal angina)
    • Inflammation of coronary arteries (e.g., vasculitis, Kawasaki disease)

    Lipoproteins

    • Lipids: cholesterol, free fatty acids, triglycerides
    • Lipids are essential for life
    • Fatty acids: energy source for skeletal and heart muscle
    • Cholesterol: builds cell membranes, steroid hormones, and bile
    • Lipids are hydrophobic, travel in blood inside lipoprotein particles

    Metabolism of Lipoproteins

    • Eating: fatty acids digested in intestinal wall, packaged in chylomicrons
    • Liver: repackages into VLDL, travels around, uploads TG and fatty acids to tissue
    • VLDL converted to LDL, circulates, eventually empties out, and returns to liver
    • Liver clears LDL from circulation, recycles it

    Atherosclerosis

    • Building of atherosclerotic plaque in artery walls, narrowing the lumen
    • Affects coronary, popliteal, carotid, and renal arteries
    • Begins in childhood, develops slowly
    • Most common causes of dyslipidemia: familial, high fat diet, high intake of refined carbs and sugars, obesity, and diabetes

    Risk Factors of Atherosclerosis and Mechanism

    • Smoking: production of reactive oxygen species, oxidative stress, damage to endothelial cells
    • Diabetes: glucose binds to blood lipids and proteins, forming AGEs, damaging endothelial cells
    • HTN: shear mechanical stress on endothelial cells, decrease in nitric oxide, vasoconstriction, and increased endothelial permeability
    • Dyslipidemia (elevated LDL): increased LDL in blood, accumulation of lipoprotein in subendothelial space

    Formation of Atherosclerotic Plaque

    • Excessive LDL deposited in endothelium, oxidized inside, producing soft lipid-loaded core
    • Platelets stick to endothelial cells, release growth factors, forming hard fibrotic cap
    • Types of atherosclerotic plaques: uncomplicated, complicated, and unstable plaques

    Unstable Plaques and Rupture

    • Oxidized LDL attracts macrophages, secreting lytic enzymes, degrading collagen of cap, leading to rupture
    • Rupture of cap: activation of platelets and clotting cascade, formation of thrombus, and ischemia

    Ischemic Heart Disease Syndromes

    • Stable ischemic heart disease (due to uncomplicated stable plaque)
    • Acute coronary syndrome (due to complicated unstable plaque)
    • Unstable angina (reversible ischemia)
    • Acute myocardial infarction (irreversible infarction)

    Stable Ischemic Heart Disease

    • Chest pain, pressure, tightness with activity, relieved with rest
    • Due to narrowing of coronary artery by stable slowly growing atherosclerotic plaque
    • When demand increases, ischemia results (demand ischemia)
    • Reversible when demand decreases (rest)
    • Subendocardial area more prone to ischemia than epicardial

    Acute Coronary Syndrome

    • Unstable angina: acute onset of chest pain/pressure at rest or unrelieved by rest
    • Due to rupture of atherosclerotic plaque with thrombosis
    • Ischemia not related to demand (supply ischemia)
    • Reversible ischemia if thrombus is broken down
    • Infarction if thrombus keeps growing

    Acute Myocardial Infarction

    • Acute onset of chest pain/pressure at rest or unrelieved by rest
    • Due to rupture of atherosclerotic plaque with 100% thrombosis
    • Main artery occlusion > transmural infarct
    • Distal branch occlusion > subendocardial infarct
    • Arterial thrombosis produces MI (necrosis, irreversible damage), not related to demand

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    Description

    This quiz covers the causes of coronary obstruction, including atherosclerosis, vasospasm, and inflammation, as well as the functions and types of lipoproteins and lipids in the body.

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