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54 Cards in this Set
- Front
- Back
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What BMI is under weight?
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less than 18.5
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What BMI is over weight?
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25.0-29.9
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What BMI is Obesity grade 1?
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30.0-34.9
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What BMI is extreme obesity?
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greater than 40
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What is a good alternative measurement to the BMI?
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waist to hip ratio
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How does being fat cause type 2 diabetes?
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more TZD from fat, means increased leptin to the brain and decreased response to insulin
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What does waist circumference indicate?
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this is a good predictor for risk factors and morbidity for pts with BMI less than 35
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What are the risk waist sizes for men and women?
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men +40
women +35 |
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where do you measure the waist?
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at the top of the iliac crests
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Where do Leptin and Adiponectin come from?
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fat cells
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where does Ghrelin come from?
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the stomach
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Where does peptide YY come from?
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ileum, colon
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What gene produces Leptin?
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ob gene (obesity)
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What gene produces the leptin receptor?
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db gene (diabetes)
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What do high leptin levels do in the body?
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these inhibit anabolic circuits- by suppressing NP-Y
stimulates catabolic pathways |
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What stage of life is Leptin associated with?
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puberty
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What does adiponectin do?
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this stimulates fatty acid oxidation, decreases fat mass
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how are adiponectin levels changed in fat people?
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fat people have lower levels of adiponectin
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how does adiponectin affect fatty acids in muscles?
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this directs fatty acids to muscles for oxidation
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what does ghrelin do?
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appetite stimulator
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where does ghrelin come from?
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arcuate nucleus of hypothalamus
empty stomach before a meal |
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How is ghrelin affected in fat people?
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suppression is attenuated in the obese
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what does peptide YY do?
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this is a satiety signal
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How does hyperinsulinemia affect free IGF levels?
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increases them
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How does hyperinsulinemia affect adiponectin levels?
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decreases them
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How does hyperinsulinemia affect Target cells?
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causes cell prolifeation
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How does hyperinsulinemia affect the insulin-sex hormone axis?
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this causes endometrial and breakst cancers
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How does being born to starved parents affect the kids?
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it makes them more prone to being fat too
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What is the basic etiology of obesity?
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eating to much and not exercising
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What is metabolic syndrome?
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central obesity
HTN high cholesterol high TAGs low HDL normal to high LDL impaired glucose |
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How does being fat cause HTN?
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excuse insulin/sugar- leads to sodium retention
increased NE production smooth muscle proliferation |
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at what BMI does type 2 DM start becoming a problem?
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at BMI's greater than 22!
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How does being fat increase your risk of clots? (thromboembolism)
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immobility, inactivity
increased PAI increased platelet activation |
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What cardiovascular effects are common risks of obesity?
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coronary heart disease
congestive heart failure stroke |
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What are the possible GI complication from being a big fat fatty?
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Gallstones are much more common
Hernias GERD Hemorrhoids NA-fatty liver |
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What are the pulmonary complications of being fat?
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Restrictive lung disease
asthma |
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What is Pickwickian syndrome, and what causes it?
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This occurs in extreme obesity
alveolar hypoventilation- acts as restrictive lung disease twitching, cyanosis, periodic breathing, secondary polycythemia |
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What are the risk factors for Sleep apnea?
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men, neck bigger than 17 inches
women neck bigger than 16 inches |
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What does sleep apnea predispose people to?
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HTN, sudden death, pulmonary edema, ARDS, sudden death
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What is narcolepsy?
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excessive daytime sleepiness without increase sleep at night.
sleep associated with sedentary boring activity |
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What types of arthritis are caused by being fat?
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degenerative weightbearing/overuse changes
knees in women, hips in men high incidence of gouty arthritis |
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What are the osteopathic structural changes in a fat person
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flattened thoracic curve T3-T5
Decreased lumboscaral curve L5 anterior to S1 Sacral extension |
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What can happen to female reproductive systems in fat people?
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irregular menstrual cycles or amenorrhea
ovulatory inftertility polycystic ovarian syndrome |
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If a fat lady does get pregnant somehow, what are the main complications during pregnancy?
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gestational diabetes and HTN
increased C-section rate increased risk of pre-eclampsia |
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What are the fetal complications of the mother being fat?
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congenital malformations- in neural tube, heart, and others
macrosomia, complication of diabetes (fat baby) |
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What are the male health risks of being fat?
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infertility
impotence |
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How does being fat affect your kidneys?
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being fat promotes type 2 DM, and HTN.
these are the number 1/2 causes of renal failure in adults |
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What are the 6 cancers that are more common in obese people
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Colon cancer
Endometrial cancer Prostate cancer Esophageal adenocarcinoma (GERD) Gallbladder cancer Renal cell carcinoma |
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How does hyperinsulinemia and insulin resistance cause cancer?
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this raises the levels of IGF-1,
which is mitogenic and anti-apoptotic |
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What skin infections are more common in fat people?
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psoriasis
taenia cruris panniculitis fourniers gangrene |
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How fast do people want to lose weight in obesity Tx?
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10% in 6 months, then 7-10% per year there after
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What kind of drug is Subutramine?
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this is an appetite suppressant for fat people
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What are the indications for weight loss surgery?
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BMI +40
BMI +35 with comorbities and failure of other methods of weight loss |
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How long does it take for appetite mediators to revert to pre fat levels?
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about a year- so they will have to maintain habits for a long time while feeling crappy
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