20. (10 points) Discuss the significance of the existence of two patternsof LDL and the relationship of small, dense LDL to dietary carbohydrate. What might it imply for the position in mainstream nutrition that saturated fat is the dietary driver of heart disease? Why do you think the information has gone mostly unmentioned despite having been discovered in 1980? 21. (10 points) Your patient recovering from a heart attack wants to know why it happened. “They said I have plaques in my arteries, and that one of them made a clot. How does that work? Isn’t it just clogged pipes from eating too much fat?” Using language a layman would understand, explain the pathophysiology of atherosclerosis. What starts the process, and how do you get from there to clot formation? You can do a paragraph or list steps. 22. (5 points) Your patient again: “They’ve had me up walking a little here on the floor since it happened ten days ago, but I could do more. My energy is finally coming back! I feel like a short jog in the fresh air would do wonders. What do you think?” 23. (5 points) The effects of myocardial infarction extend to heart tissue not directly affected by the ischemia. Name three molecular mechanisms behind the general loss of myocardial contractility. 24. (5 points) Explain how myocardial infarction can lead to pulmonary edema, and why this is more characteristic of LV infarction than RV infarction. 25. (10 points) Why are SNS and RAAS activation in chronic heart failure beneficial? Name three specific cardiovascular effects involved. 26. (10 points) Why are SNS and RAAS activation in chronic heart failure harmful? Name five detrimental effects. 27. (5 points) Why is ventricular fibrillation more immediately life-threatening than atrial fibrillation? Social Science Sociology CLINICAL 1727