NSG./533./Advanced./Pathophysiology./Exam./3
1. List./the./novel./risk./factors./for./CAD:./1)./markers./of./inflammation,./ischemia,./and./thrombosis./(elevated.
/high./sensitivity./C-
reactive./protein,./troponin,./fibrinogen)./2)./adipokines./(leptin,./adiponectin)./3)./CKD./4)./air./pollution./and./ionizing./ra
diation./5)./medications./(NSAIDs)./6)./coronary./artery./calcification./and./carotid./wall./thickness./and./7)./microbiome./8)
./small./dense./LDL./particles./and./lipoprotein(a)./9)./Hyperhomocysteinemia
2. List./nonmodifiable./risk./factors./for./CAD:./Advanced./age,./male./gender./or./woman./afte
r./menopause,./and./family./history./(genetics,./shared./environmental./exposure).
3. List./modifiable./risk./factors./for./CAD:. / Dyslipidemia,./hypertension,./cigarette./smoking,./diabetes./and
./insulin./resistance,./obesity./and./sedentary./lifestyle,./and./an./atherogenic./diet.
4. How./does./dyslipidemia./contribute./to./CAD?:./High./levels./of./LDL./in./the./bloodstream./leads./t
o./LDL./oxidation,./migration./into./the./vessel./wall,./and./phagocytosis./by./macrophages,./all./key./steps./in./the./pathoge
nesis./of./atherosclerosis.
5. Atherosclerosis:. / A./chronic./inflammatory./condition./that./results./in./damage./to./the./arteries../Thickening./and
hardening./of./the./vessels./are./caused./by./the./accumulation./of./lipid-
laden./macrophages./(foam./cells)./within./the./arterial./walls,./leading./to./the./formation./of./a./plaque.
6. Optimal. / lipid. / panal. / results:. / Total./cholesterol./(<./200),./LDL./(<./100),./triglycerides./(<./150)
7. What. / is. / the. / response-to-
injury. / hypothesis. / in. / the. / development. / of. / atheroscle-
rotic./lesions?:./The./earliest./event./in./atherogenesis./is./injury./to./the./endothelium,./which./could./be./triggered./by.
/ hypertension,./circulation./of./ROS./(smoking,./pollutants),./dyslipidemia,./and./elevated./A1C.
8. When./foam./cells./accumulate./in./a./significant./amount./within./the./arterial./wall
,./they./form./
../What./is./then./released?:./a./lesion./called./a./fatty./streak;./inflammatory./cytokines,./damaging./enzymes,.
/and./growth./factors.
9. Growth./ factors./ released./ released./ in./ atherogenesis./ stimulate./ ,./which
.:. / smooth./muscle./cell./proliferation;./produce./collagen./and./migrate./over./the./fatty./streak./to./form./a./fibrou
s
plaque.
10. Plaques. / that. / have. / ruptured. / are. / called. / .:. / complicated./plaques
11. Plaque./ rupture./ occurs./ because./ of./ the./ .:./inflammatory./activation./of./proteinases,
apoptosis./of./cells./within./the./plaque,./and./bleeding./within./the./lesion./(plaque./hemorrhage).
12. What./happens./once./a./plaque./ruptures?:./The./underlying./tissue./is./exposed./and./causes./platele
./ .
/
, NSG./533./Advanced./Pathophysiology./Exam./3
t./adhesion,./initiation./of./the./clotting./cascade,./and./rapid./thrombus./formation./that./can./suddenly./occlude./the./vesse
l,./resulting./in./ischemia./and./infarction.
13. Stable. / atheromatous. / lesions:. / A./fibrous./plaque./that./has./calcified,./protruded./into./the./vessel./lume
n,
and./obstructs./blood./flow,./causing./chest./pain./during./exercise./(stable./angina)
./ .
/
1. List./the./novel./risk./factors./for./CAD:./1)./markers./of./inflammation,./ischemia,./and./thrombosis./(elevated.
/high./sensitivity./C-
reactive./protein,./troponin,./fibrinogen)./2)./adipokines./(leptin,./adiponectin)./3)./CKD./4)./air./pollution./and./ionizing./ra
diation./5)./medications./(NSAIDs)./6)./coronary./artery./calcification./and./carotid./wall./thickness./and./7)./microbiome./8)
./small./dense./LDL./particles./and./lipoprotein(a)./9)./Hyperhomocysteinemia
2. List./nonmodifiable./risk./factors./for./CAD:./Advanced./age,./male./gender./or./woman./afte
r./menopause,./and./family./history./(genetics,./shared./environmental./exposure).
3. List./modifiable./risk./factors./for./CAD:. / Dyslipidemia,./hypertension,./cigarette./smoking,./diabetes./and
./insulin./resistance,./obesity./and./sedentary./lifestyle,./and./an./atherogenic./diet.
4. How./does./dyslipidemia./contribute./to./CAD?:./High./levels./of./LDL./in./the./bloodstream./leads./t
o./LDL./oxidation,./migration./into./the./vessel./wall,./and./phagocytosis./by./macrophages,./all./key./steps./in./the./pathoge
nesis./of./atherosclerosis.
5. Atherosclerosis:. / A./chronic./inflammatory./condition./that./results./in./damage./to./the./arteries../Thickening./and
hardening./of./the./vessels./are./caused./by./the./accumulation./of./lipid-
laden./macrophages./(foam./cells)./within./the./arterial./walls,./leading./to./the./formation./of./a./plaque.
6. Optimal. / lipid. / panal. / results:. / Total./cholesterol./(<./200),./LDL./(<./100),./triglycerides./(<./150)
7. What. / is. / the. / response-to-
injury. / hypothesis. / in. / the. / development. / of. / atheroscle-
rotic./lesions?:./The./earliest./event./in./atherogenesis./is./injury./to./the./endothelium,./which./could./be./triggered./by.
/ hypertension,./circulation./of./ROS./(smoking,./pollutants),./dyslipidemia,./and./elevated./A1C.
8. When./foam./cells./accumulate./in./a./significant./amount./within./the./arterial./wall
,./they./form./
../What./is./then./released?:./a./lesion./called./a./fatty./streak;./inflammatory./cytokines,./damaging./enzymes,.
/and./growth./factors.
9. Growth./ factors./ released./ released./ in./ atherogenesis./ stimulate./ ,./which
.:. / smooth./muscle./cell./proliferation;./produce./collagen./and./migrate./over./the./fatty./streak./to./form./a./fibrou
s
plaque.
10. Plaques. / that. / have. / ruptured. / are. / called. / .:. / complicated./plaques
11. Plaque./ rupture./ occurs./ because./ of./ the./ .:./inflammatory./activation./of./proteinases,
apoptosis./of./cells./within./the./plaque,./and./bleeding./within./the./lesion./(plaque./hemorrhage).
12. What./happens./once./a./plaque./ruptures?:./The./underlying./tissue./is./exposed./and./causes./platele
./ .
/
, NSG./533./Advanced./Pathophysiology./Exam./3
t./adhesion,./initiation./of./the./clotting./cascade,./and./rapid./thrombus./formation./that./can./suddenly./occlude./the./vesse
l,./resulting./in./ischemia./and./infarction.
13. Stable. / atheromatous. / lesions:. / A./fibrous./plaque./that./has./calcified,./protruded./into./the./vessel./lume
n,
and./obstructs./blood./flow,./causing./chest./pain./during./exercise./(stable./angina)
./ .
/
