Patho & Pharmo wk 4 Atherosclerosis (AS)
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. What would you like to do?
- A. Thickening of the artery wall
- B. Hardening of the artery wall
- C. Loss of elasticity
- D. Responsible for 40-50% of Australian Mortality
- E. All of the above
What are the risk factors of AS
Smoking, Diabetes, family history, obesity, gender, menopause & hypertension
What is the initial start to AS?
Sub-endothelial fatty streaks followed by the gradual development of atheromatous plaques
I’m a raised fatty lesion. I contain lipids of different
levels and debris that has occurred from cellular function. Fibrous tissue. Calcification. What am I?
- A. Embolus
- B. Thrombus
- C. Plaque
- D. Aneurysms
Where can plaques occur?
Abdominal aorta, Coronary arteries, Popliteal arteries, Descending thoracic aorta, internal carotid arteries and the circle of willis
What is the function of LDLs?
LDLs are lipoproteins that deliver cholesterol to the tissues that require it as a membrane structure and hormone precursor.
What is transported in chylomicrons?
Dietary cholesterol and Triglycerides
What part does the liver play?
The liver manufactures bile acids that attaches to the cholesterol and a carrier complex
Which are the worse high levels of HDL or LDL?
In the coronary arteries if AS or CAD is present what may this lead to?
Angina, heart failure and Myocardial infarction
Describe an arterial aneurysm?
A swelling of the arterial wall, which has been weakened by trauma, infection (syphilis), congenital defects or AS
Name the 3 types of aneurysms?
Berry, fusiform and dissecting
What is frequently the cause for acute occlusion?
Peripheral Vascular Disease is commonly caused by AS especially in the lower limbs due to atrophy of muscles and skin due to poor wound healing.
What are a CVA and a TIA?
Cerebrovascular accident & Transit Ischemic attack
Is it possible that the kidneys can be affected by AS?
Yes. Due to the reduced blood flow to the kidneys they responds by activating renin-angiotensin aldosterone system, leading to vasoconstriction and fluid retention, increasing BP.
- DVT is deep vein thrombous.
- This can be due to immobility or post operative.
- The embolise travels back to the heart in dioxidise blood via the veins.
- To the right artrium
- Pumps into RV
- Pumps into pulmonary artery.
- Into the Lungs - If emboli is large it will cause death; if sml it will pass through and lodge in a smaller artery & cause AS later on.
Name the 5 stages of Haemostasis?
- Vessel spasm - smooth muscle contraction - Reduce BF
- Formulation of platelet plug - Platelet release ADP & TXA2
- Blood coagulation (Fibrin clot) Activation; protein
- Clot retraction - Shrinkage of the clot
- Clot dissolution - Removal
What does anti-thrombin do?
Inactivates clotting factors which stray from the injury site; slow down haemostasis.
I am a drug that enhances the action of antithrombin. What is my name?
List the differences between Hyper and Hypocoagulability?
- Hypercoagulability - Increased platelet function, increased blood coagulation, treatment preventing and removing thrombi.
- Hypocoagulability - A platelet disorder, coagulation factor deficiences
What does DIC mean?
Disseminated intravascular coagulation - To much coagulation followed by not enough; mass bruising
How does Virchos Triad relate to Thrombis?
- Endothelial injury
- Avnormal BF
If 2 out 3 then increased risk of forming thrombis.
Name the 3 drugs that are used in a Thrombis situation and state if they are a prevention or removal drug?
- Antiplatelet - Suppress platelet aggergration (Asprin) Preventative
- Anticoagulants - Reduce fibrin formation (Warfarin, Heparin(IM)) Preventative
- Thrombolytics - Break up thrombi (Alteplase & Streptokinase) Removal
I am usually associated with turbulent BF and endothelial injury with the activation of platelets. What am I?
I am usually associated with stasis of BF and the activation of coagulation pathway. What am I?
Name 6 ways to reduce cholesterol?
- Red wine - As it increase HDL's & decreases plaque deposition
- Olive oil
- Fish oil
- Anti hyperlipidaemia
- Prevastin & Simvastin
What would you like to do?
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