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35 Cards in this Set
- Front
- Back
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What is the source, stimulus, and effect of Ghrelin?
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Source: stomach
Stimulus: fasting Effect: NPY release--> feeding |
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What is the source, stimulus, and effect of Insulin?
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Source: Pancreas
Stimulus: carbohydrate intake Effect: alpha-MSH release--> satiety |
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What is the source, stimulus, and effect of Leptin?
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Source: Adipocytes
Stimulus: basal production, overeating, hyperinsulinemia Effect: Inhibits NPY, stimulates α-MSH--> satiety |
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What is the source, stimulus, and effect of Peptide YY?
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Source: ileocolonic enteroendocrine cells
Stimulus: undigested nutrients Effect: Inhibits NPY, GI sec/mot-->Satiety |
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What are 3 genes that are implicated in obesity?
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- Agouti
- Leptin - MC4R |
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To what receptor does agouti bind?
What are the consequences of this? |
binds to MC4R competitively inhibiting MSH
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What effect does significant weight loss have on ghrelin and leptin?
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Increases ghrelin and decrease leptin
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If feeding is stimulated, what happens to metabolic rate?
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It decreases
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What is classified as underweight in children?
adults? |
Children: <5th percentile
Adults: BMI <18.5 |
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What is classified as normal weight in children?
adults? |
Children: 5th-85th percentile
Adults: BMI 18.5-24.9 |
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What is classified as overweight in children?
adults? |
Children: 85th-95th percentile
Adults: BMI 25-29.9 |
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What is classified as obese in children?
adults? |
children: >95th percentile
Adults: BMI >30 |
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What causes metabolic syndrome?
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Free fatty acids in the blood stream
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When BMI is not accurate, what else is used?
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Waist circumference
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What waist circumference suggests metabolic syndrome in men?
women? |
Men: 40"+
Women: 35"+ |
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Of all the 5 characteristics that define metabolic syndrome, which one is directly causative for the disease?
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Central obesity (abdominal adiposity)
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What effects do circulating fatty acids have on the liver, muscles, and pancreas?
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Liver: increased release of glucose, TGs, VLDL
Muscles: insulin resistance and TG accumulation Pancreas: increased insulin release |
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How much does metabolic syndrome increase the risk of CV disease or death?
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2.5x
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What condition does not increase with morbid obesity?
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Hyperlipidemia
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Besides T2DM and HTN, what other consequences would obesity have in adolescents? (4)
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- NAFLD
- Cholelithiasis - Obstructive sleep apnea - Slipped capital femoral epiphysis |
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What does a lowfat diet do to BMR?
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Lowers it
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What does a low-carb diet do to BMR?
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Increases it
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What are the indications for bariatric pharmacotherapy? (2)
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BMI 27-29.9 + one other disorder
(HTN, glucose intolerant, DM, hyperlipidemia, obstructive sleep apnea) or just BMI >30 |
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How much additional weight loss above dieting would 1 year of drug-use will Rx lead to?
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3 kg
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What is the MoA of orlistat?
What are its adverse effects? |
- Pancreatic lipase inhibitor
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What is the MoA of Lorcaserin?
What are its adverse effects? |
SE agonist
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Name 4 sympathomimetics used to curb appetite.
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- Phentermine
- Diethylpropion - Benzphetamine - Phendimetrazine |
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What are adverse effects of bariatric sympathomimetics? (3)
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- Increased HR
- Increased BP - Increased risk of CVD |
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Name an antiepileptic that is used for weightloss.
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Topiramate
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What is the best bariatric surgery for long term weight-loss?
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Roux-en-Y gastric bypass surgery
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What are the indications for bariatric surgery?
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BMI over 40 or high risk conditions
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What high risk conditions would allow a patient under BMI 40 to receive bariatric surgery? (4)
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- Severe sleep apnea
- Cardiomyopathy - Severe DM - Joint disease |
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Describe the Roux-en-Y surgery?
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Fundus of stomach severed from body and made into a blind pouch. Jejunum then connected to this fundus, while distal duodenum connected to mid-jejunum
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What are some adverse effects of Roux-en-Y? (6)
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- Obstructions and strictures
- Anastomotic leaks - Erosions and ulcers - Adhesions - Hernias - Cholelithiasis |
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What is dumping syndrome?
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Rapid gastric emptying leading to hyperosmolarity and rapid fluid shifts in the gut causing symptoms
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