PAT 201 WEEK 11 EXAM QUESTIONS
AND ANSWERS
What are the indications for atorvastatin? - Answer--Hypercholesterolemia
-Elevated triglycerides
What is the desired effect of atorvastatin? - Answer--Decrease cholesterol and LDLs
-Increase HDL levels
What are adverse effects of atorvastatin? - Answer--Headache
-Abdominal cramps
-Constipation
-Nausea
-Diarrhea
-Heartburn
-Rash
What is the mechanism of action of atorvastatin? - Answer--Inhibit HMG-CoA reductase
-> decrease cholesterol
-Increase number of LDL receptors on liver cells
What is a significant interaction of atorvastatin? - Answer--Grapefruit juice (inhibits
metabolism of statins -> rhabdomyolysis -> clog kidneys -> ARF
What is the first drug of choice for decreasing lipid levels? - Answer-Atorvastatin
What is atherosclerosis? - Answer--Form of arteriosclerosis
-Thickening and hardening caused by accumulation of lipid-laden macrophages in
arterial wall
-Chronic inflammatory condition
True or false: atherosclerosis is the leading cause of coronary artery disease (CAD) and
cerebrovascular disease - Answer-True
What is the progression of atherosclerosis? - Answer-Damaged endothelium -> LDL
oxidation -> fatty streak formation -> fibrous plaque
What are some examples of factors that cause endothelial cell injury? - Answer--
Smoking
, -HTN
-DM
Damaged endothelium stops making what substances - Answer-Antithrombotic and
vasodilatory (NO and prostaglandins)
What happens as a result of damaged endothelium? - Answer--Promotes adhesion of
monocytes and other inflammatory cells.
-Produces reactive oxygen species (formed from O2 and damage molecules)
What is the correct sequence of events of LDL oxidation?
1. Activated macrophages engulf oxidized LDL
2. LDL penetrates arterial walls and becomes trapped
3. Macrophages full of LDL transform into foam cells
4. Inflammation, oxidative stress and activation of macrophages oxidizes LDL - Answer-
2
4
1
3
What is the most common cause of coronary artery diseases? - Answer-Atherosclerosis
Why are plaques unstable and prone to rupture? - Answer--Inflammatory activation of
proteinases
-Apoptosis (death) of cells in the plaque
-Plaque hemorrhage
-Plaques are clinically silent until they rupture
Explain fibrous plaques - Answer--Calcify & protrude into vessel lumen
-Obstruct blood flow to distal tissues
Someone with atherosclerosis may experience ____ during exercise - Answer-Angina
or intermittent claudication (leg cramps)
What is a complicated plaque? - Answer-Plaques that have ruptured
What medication is for the prevention of plaque? - Answer-Antithrombotic agents (ASA)
What is the pathophysiology of complex plaque formation - Answer--Exposed
underlying tissue
-Platelet adhesion
-Initiation of clotting cascade
-Rapid thrombus formation
-Sudden occlusion of vessel
-Ischemia or infarction
AND ANSWERS
What are the indications for atorvastatin? - Answer--Hypercholesterolemia
-Elevated triglycerides
What is the desired effect of atorvastatin? - Answer--Decrease cholesterol and LDLs
-Increase HDL levels
What are adverse effects of atorvastatin? - Answer--Headache
-Abdominal cramps
-Constipation
-Nausea
-Diarrhea
-Heartburn
-Rash
What is the mechanism of action of atorvastatin? - Answer--Inhibit HMG-CoA reductase
-> decrease cholesterol
-Increase number of LDL receptors on liver cells
What is a significant interaction of atorvastatin? - Answer--Grapefruit juice (inhibits
metabolism of statins -> rhabdomyolysis -> clog kidneys -> ARF
What is the first drug of choice for decreasing lipid levels? - Answer-Atorvastatin
What is atherosclerosis? - Answer--Form of arteriosclerosis
-Thickening and hardening caused by accumulation of lipid-laden macrophages in
arterial wall
-Chronic inflammatory condition
True or false: atherosclerosis is the leading cause of coronary artery disease (CAD) and
cerebrovascular disease - Answer-True
What is the progression of atherosclerosis? - Answer-Damaged endothelium -> LDL
oxidation -> fatty streak formation -> fibrous plaque
What are some examples of factors that cause endothelial cell injury? - Answer--
Smoking
, -HTN
-DM
Damaged endothelium stops making what substances - Answer-Antithrombotic and
vasodilatory (NO and prostaglandins)
What happens as a result of damaged endothelium? - Answer--Promotes adhesion of
monocytes and other inflammatory cells.
-Produces reactive oxygen species (formed from O2 and damage molecules)
What is the correct sequence of events of LDL oxidation?
1. Activated macrophages engulf oxidized LDL
2. LDL penetrates arterial walls and becomes trapped
3. Macrophages full of LDL transform into foam cells
4. Inflammation, oxidative stress and activation of macrophages oxidizes LDL - Answer-
2
4
1
3
What is the most common cause of coronary artery diseases? - Answer-Atherosclerosis
Why are plaques unstable and prone to rupture? - Answer--Inflammatory activation of
proteinases
-Apoptosis (death) of cells in the plaque
-Plaque hemorrhage
-Plaques are clinically silent until they rupture
Explain fibrous plaques - Answer--Calcify & protrude into vessel lumen
-Obstruct blood flow to distal tissues
Someone with atherosclerosis may experience ____ during exercise - Answer-Angina
or intermittent claudication (leg cramps)
What is a complicated plaque? - Answer-Plaques that have ruptured
What medication is for the prevention of plaque? - Answer-Antithrombotic agents (ASA)
What is the pathophysiology of complex plaque formation - Answer--Exposed
underlying tissue
-Platelet adhesion
-Initiation of clotting cascade
-Rapid thrombus formation
-Sudden occlusion of vessel
-Ischemia or infarction
