What does hyperlipidemia lead to?
____________ is intimately involved in the formation of Atherosclerosis.
What are some examples of arterial diseases?
Atherosclerois, Aneurysm, Inflammatory disease, and Raynaud phenomenon
What is the difference between an artery and a vein?
One has values and carries deoxygenated blood. The other carries oxygenated blood, under high pressure and is surrounded by a thick layer of smooth muscle.
Name some diseases of veins:
Thrombus, Varicose veins, and Chronic venous insufficiency
What are the manifestations of atherosclerosis?
CAD, MI, Stroke, PVD
What are the characteristics of hyperlipidemia?
Plasma cholesterol and triglyceride levels that are above the "normal" range.
What is the newer name for hyperlipidemia?
What is the cause of hyperlipidemia?
Combination of a lot of things: high LDLs and BV injury
What is a lipoprotein?
Large macromolecules used to transport dietary lipids in the plasma
What are some examples of dietary lipids?
Cholesterol, Triglycerides, Phospholipids
In the body what is cholesterol used for?
Building block for steroid hormones, plasma membrane fluidity, and bile salt production.
In the body what are triglycerides used for?
Energy, energy stores
In the body what are phospholipids used for
How are dietary lipids transported in the plasma?
What are the components of a lipoprotein?
Hydrophobic core, surface layer of phospholipids, and apolipoprotein.
___________ of a lipoprotein is made up of cholesterol esters, non-polar triglycerides.
What is the hydrophobic core of lipoproteins made up of?
Cholesterol esters, and non-polar triglycerides
What is the function of an apolipoprotein?
Allow for lipoproteins to bind to cell receptors and a cofactor for lipid metabolizing enzymes.
What is the function of a lipoprotein?
What are the four classes of lipoproteins based on?
What lipoprotein has the lowest density?
What lipoprotein has the highest density?
What is the order of density of a lipoprotein from highest to lowest?
HDL, LDL, VLDL, Chylomicron
What is the order of density of a lipoprotein from lowest to highest?
Chylomicron, VLDL, LDL, HDL
What are the characteristics of chylomicrons?
What are the characteristics of VLDL?
What are the characteristics of LDL?
What are the characteristics of HDL?
How do fats get to the liver?
Packaged as a chylomicron and sent through the blood
Where are dietary triglycerides and cholesterol absorbed?
What does the liver do when chylomicron enter the liver?
Absorb some, but bulk is repackaged and transported as VLDL in the blood.
What lipoproteins does the liver produce?
As _____ travels through the blood and tissues it progresses to ______.
Where is VLDL synthesized?
Where does VLDL become IDL?
What is the primary culprit in atherosclerosis?
_____________ on tissue take up the lipoprotein.
LDL in complex with LDL-R is take into the cell via what process?
Cholesterol is released from the cell via ___________ to make amino acids.
Why are LDL molecules considered "bad cholesterol"?
Transport cholesterol to the tissues, cause inflammation and atherosclerosis.
Why are HDL's considered "good cholesterol"?
Involved in reverse cholesterol transport, removes cholesterol from the tissue and brings it back to the liver for storage.
HDL is involved in _____________?
Reverse cholesterol transport
What organization sets the standard for serum lipid profile?
What does NCEP stand for?
National Cholesterol Education Panel
What are the ranges for LDL cholesterol?
100-129 Near optimal/above optimal
130-159 Borderline high
>190 Very high
What are the ranges for HDL cholesterol?
What diseases are associated with hyperlipidemia?
Diabetes, hypothyroidism, and liver disease
What are some causes of hyperlipidemia?
Diet, Obesity, GENETICS, Drugs, Diseases, and Alcohol.
What drugs can cause hyperlipidemia?
Beta-blockers and oral contraceptives
What are examples of genetic hyperlipidemia?
What are the causes of familial hypercholesterolemia and hypertriglyceridemia?
Lack of LDL receptors or Apoprotein. Caused by a gene deficiency.
What are the keys to managing hyperlipidemia?
Diet, modify risk factors, and drug therapy.
What is the target for statin drugs to treat hyperlipidemia?
HMG CoA Reductase
What is atherosclerosis?
Formation of "fibrofatty" lesions in the wall of BVs
What vessels are the most susceptible to atherosclerosis?
What arteries are the most effected by atherosclerosis?
Abdominal aorta and iliac arteries
After what age is it a risk for men to develop atherosclerosis?
After what age is it a risk for women to develop atherosclerosis?
Why is there a difference in age between men and women for atherosclerosis risk?
Women produce estrogen up until menopause.
What is the first step in atherosclerosis?
Endothelial Cell Injury
What is the second step in atherosclerosis?
Migration of Inflammatory Cells
What is the third step in atherosclerosis?
What is the fourth step in atherosclerosis?
What are some main causes of endothelial injury?
Smoking, hypertension, hyperlipidemia, toxins
In what ways are injured endothelial cells dysfunctional?
1. Fail to produce endogenous vasodilators like Nitric Oxide.
2. Fail to make anti-thrombotic cytokines like Prostacyclin.
What is Nitric Oxide?
What is Prostacyclin?
What is an example of a endogenous vasodilator produced by endothelial cells?
What is an example of a anti-thrombotic cytokine produced by endothelial cells?
What happens during the migration of immune cells step of atherosclerosis?
1. Monocyte & neutrophils enter injured endothelium.
2. Cells encounter & oxidize LDL's molecules
3. May directly injure vascular endothelium
What does the phagocytization of LDL's lead to?
Foam cells that release growth factors that increase proliferation of vascular smooth muscle.
What do foam cells produce?
What does the release of growth factors by foam cells lead to?
Proliferation of vascular smooth muscle.
What are the characteristics of the plaque formation step in atherosclerosis?
Necrotic core forms covered by a thin fibrous "cap"
What are the manifestations of atherosclerosis?
Myocardial ischemia, weakening of blood vessel wall (aneurysm, stroke) and peripheral vascular disease (PVD)
What is an aneurysm?
Localized dilation or out-pouching of a vessel of the heart chamber.
What are the most susceptible areas for an aneurysm to occur?
What are the potential causes of an aneurysm?
Atherosclerosis, Hypertension, Marfan Syndrome, and Aging
What are the two types of a "true aneurysm?"
What are the characteristics of a fusiform circumferential aneurysm?
Widening of the BV all the way around due to aneurysm.
What are the characteristics of a fusiform saccular aneurysm?
A out-pouching of a BV due to an aneurysm.
What is a "false aneurysm?"
Results from trauma but blood is contained by a clot. Usually heals itself.
What is a "dissecting Aneurysm?"
BV wall is split open and bleeding is contained by the connective tissue around.
What time of aneurysm requires immediate medical attention?
What are the typical manifestations of an aneurysm?
Vary widely, may be asymptomatic
What are the manifestations of a Thoracic Aneurysm?
Dysphagia, Dyspnea, Neck, back, and shoulder pain.
Dysphagia, Dypsnea, neck, back and shoulder pain are examples of manifestations of what type of aneurysm?
What are the manifestations of an aneurysm contained in the abdominal cavity?
Impaired blood flow/return, less likely to yield symptoms.
What are the manifestations of a cerebral aneurysm?
Headache, increased intracranial pressure
What are common treatments for aneurysms?
Reduce BP, Smoking cessation, and surgical repair (grafting or wrapping).
Coiling is a common treatment for why type of aneurysm?