What is the initiating event that leads to the development of atherosclerosis?

Injury to the endothelial cells that line the artery walls

Release of the platelet-deprived growth factor

Macrophages adhere to vessel walls

Release of the inflammatory cytokines

Answer and Explanation

The Correct Answer is A

A. Injury to the endothelial cells that line the artery walls: The development of atherosclerosis begins with damage to the endothelial cells of the arterial wall. This injury can be caused by various factors, including hypertension, smoking, high cholesterol, and diabetes. Once the endothelium is injured, it becomes more permeable, allowing lipids and inflammatory cells to penetrate and accumulate, leading to the formation of atherosclerotic plaques.

B. Release of the platelet-derived growth factor: While platelet-derived growth factor (PDGF) plays a role in the proliferation of smooth muscle cells and the progression of atherosclerosis, it is not the initiating event. PDGF is released in response to endothelial injury and inflammation but does not cause the initial damage itself.

C. Macrophages adhere to vessel walls: The adherence of macrophages to the vessel walls occurs after the initial endothelial injury. Once the endothelium is damaged, macrophages migrate to the site and contribute to the inflammatory response and plaque formation, but this is not the initiating event.

D. Release of inflammatory cytokines: Inflammatory cytokines are part of the response that follows endothelial injury and play a role in the progression of atherosclerosis. However, the release of these cytokines is a consequence of the initial injury rather than the initiating event.

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Correct Answer is A

Explanation

A. Carotid wall thinness: Carotid wall thinness is not considered a nontraditional risk factor for coronary artery disease (CAD). Traditional risk factors for CAD include age, gender, hypertension, hyperlipidemia, and smoking, while carotid wall thickness (rather than thinness) is often used as a marker for atherosclerosis and cardiovascular risk.

B. Chronic kidney disease: Chronic kidney disease (CKD) is recognized as a nontraditional risk factor for coronary artery disease. It is associated with increased cardiovascular risk due to factors like inflammation, mineral metabolism disorders, and increased vascular stiffness.

C. Coronary artery calcification: Coronary artery calcification is considered a nontraditional risk factor for CAD. It reflects the presence of atherosclerosis and is associated with an increased risk of cardiovascular events.

D. Markers of inflammation, ischemia, and thrombosis: Markers of inflammation (such as C-reactive protein), ischemia, and thrombosis (such as fibrinogen and D-dimer) are nontraditional risk factors for coronary artery disease. Elevated levels of these markers indicate increased cardiovascular risk and are used in risk stratification.

A. Is caused by hypertrophy and hyperplasia with associated fibrosis of the intima and media B. Underactivity of the sympathetic nervous system and the RAAS C. is caused by complicated interactions of genetics and the environment without evidence of a specific causative agent D. is caused by systemic disease that raises peripheral vascular resistance and/or cardiac output

Correct Answer is C

Explanation

A. Is caused by hypertrophy and hyperplasia with associated fibrosis of the intima and media: While these changes can occur in the vascular walls over time due to hypertension, they are not the primary cause of primary hypertension itself. Primary hypertension is more complex and multifactorial.

B. Underactivity of the sympathetic nervous system and the RAAS: Primary hypertension is characterized by increased activity of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS), not underactivity. Increased activity of these systems contributes to elevated blood pressure.

C. Is caused by complicated interactions of genetics and the environment without evidence of a specific causative agent: This statement accurately describes primary hypertension, which results from a combination of genetic predisposition and environmental factors such as diet, physical activity, and stress. There is no single identifiable cause for primary hypertension, making this the correct answer.

D. Is caused by systemic disease that raises peripheral vascular resistance and/or cardiac output: This statement pertains more to secondary hypertension, which is due to identifiable causes such as kidney disease, endocrine disorders, or other systemic diseases. Primary hypertension does not arise from a specific systemic disease but rather from multifactorial influences.

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What is the initiating event that leads to the development of atherosclerosis?

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Naxlex Comprehensive Predictor Exams

All of the following are nontraditional risk factors of coronary artery disease except:

Correct Answer is A

Explanation

Primary hypertension:

Correct Answer is C

Explanation

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