Atherosclerosis Quiz

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Questions and Answers

What can occur if a thrombus becomes large enough?

It prevents the formation of an embolus.

It can occlude blood flow, causing ischemia. (correct)

It can form a platelet plug.

It leads to increased blood flow.

Which of the following is a non-modifiable risk factor for atherosclerosis?

Age. (correct)

Dyslipidemia.

Obesity.

Smoking cigarettes.

Which risk factor directly contributes to dyslipidemia?

Sedentary lifestyle. (correct)

Genetic predisposition.

High sugar diet.

Chronic infections.

What is controversial regarding chronic infections and atherosclerosis?

Their role in chronic vascular inflammation is debated. Signup and view all the answers

Which of the following is a key driver of atherogenesis?

High LDL cholesterol. Signup and view all the answers

Which lifestyle factor contributes to increased risk of metabolic syndrome?

Sedentary lifestyle. Signup and view all the answers

What effect does hypertension have on blood vessels?

It causes endothelial injury. Signup and view all the answers

What is associated with a higher risk of cardiovascular disease in postmenopausal women?

Loss of estrogen. Signup and view all the answers

What initiates the process of atherosclerosis?

Endothelial injury from various risk factors Signup and view all the answers

Which of the following substances is critical in the development of fatty streaks?

Oxidized low-density lipoprotein (LDL) Signup and view all the answers

During the process of atherosclerosis, what happens during the formation of a fibrous plaque?

Smooth muscle cells migrate and proliferate, creating a fibrous cap Signup and view all the answers

Which factor does NOT contribute to endothelial dysfunction?

Inflammation from infections Signup and view all the answers

What characterizes the complicated plaque stage in atherosclerosis?

Rupture of the plaque and exposure of thrombogenic core Signup and view all the answers

What occurs during the fatty streak formation stage of atherosclerosis?

LDL particles penetrate the endothelium and oxidize Signup and view all the answers

What increases the risk of plaque rupture in atherosclerosis?

Lipid-rich core under a thin fibrous cap Signup and view all the answers

Which of the following processes happens first in the development of atherosclerosis?

Endothelial dysfunction Signup and view all the answers

Study Notes

Atherosclerosis

A chronic inflammatory disease caused by lipid-laden macrophages accumulating in artery walls, forming plaques.
Initiated by endothelial injury, due to factors like hypertension, dyslipidemia, smoking, and diabetes.
Oxidized LDL plays a vital role in macrophage uptake, forming foam cells, and contributing to fatty streaks (the earliest atherosclerotic lesion).

Pathophysiology of Atherosclerosis

Endothelial Dysfunction: Injury to the endothelium (inner lining of blood vessels) from risk factors like hypertension, smoking & diabetes causes inflammation and impaired production of protective factors like nitric oxide. Adhesion molecules increase on the injured surface to attract immune cells (like monocytes/T-lymphocytes).
Fatty Streak Formation: Oxidized LDL penetrates the injured endothelium and gets engulfed by macrophages, forming foam cells. These clustered foam cells form the first visible atherosclerotic lesions.
Fibrous Plaque Formation: Smooth muscle cells migrate to the tunica intima (inner layer of the vessel wall) and proliferate. They secrete extracellular matrix components (like collagen & elastin), forming a fibrous cap over the lipid core, stabilizing the plaque, but maintaining the risk of rupture.
Complicated Plaque (Rupture) and Thrombus Formation: Exposure of the thrombogenic lipid core and extracellular matrix proteins to the bloodstream activates platelets, leads to platelet plug formation, and eventually a thrombus (blood clot). Thrombus can be large enough to occlude blood flow, causing ischemia or infarction.

Disease Transmission

Atherosclerosis is not contagious.
Environmental exposure to risk factors (like secondhand smoke) can indirectly influence development.
Some evidence suggests a role for certain infections (e.g., Chlamydia pneumoniae) in chronic vascular inflammation, but this is controversial.

Risk Factors for Atherosclerosis

Non-modifiable: Age, sex, ethnicity, family history.
- Risk increases with age, men generally have a higher risk, and post-menopausal women experience increased risk due to estrogen loss. Specific ethnic groups and those with a family history of early-onset cardiovascular disease are at higher risk.
Modifiable:
- Dyslipidemia: High LDL and low HDL cholesterol are key drivers.
- Hypertension: Damages endothelium and promotes plaque formation.
- Smoking: Oxidizes LDL, damages endothelium, and increases blood clotting.
- Diabetes: Chronic hyperglycemia damages the endothelium and promotes inflammation.
- Obesity/Increased waist circumference: Associated with metabolic syndrome (insulin resistance, hypertension, and dyslipidemia).
- Sedentary lifestyle: Contributes to metabolic syndrome and obesity.
- Diet: Diets high in saturated and trans fats, and simple sugars increase risk.
- Additional Factors: Inflammation markers (e.g., CRP), microbiome changes (e.g., TMAO production) also contribute to atherosclerosis development.

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Description

This quiz explores the mechanisms behind atherosclerosis, a chronic inflammatory disease affecting arteries. It delves into endothelial dysfunction, the role of oxidized LDL, and the formation of fatty streaks. Test your understanding of the disease's progression and contributing risk factors.