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Endocrine > 179. Pathophysiology of Obesity > Flashcards

179. Pathophysiology of Obesity Flashcards

1
Q

Most clinically useful analysis technique

- indirectly related to body fat

A

Bioelectrical impedance analysis (BIA)

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2
Q

Increased pressure dynamics in the abdominal compartment may lead to __ and __ __

A

GERD

Urinary incontinence

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3
Q

Most common determinant of Metabolic Syndrome

A

High waist circumference

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4
Q

Directly decreases insulin sensitivity and increases lipolysis in adipocytes

A

TNF-alpha

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5
Q

Abundant adipose-derived protein whose levels are reduced in obesity

  • enhances insulin sensitivity and lipid oxidation
  • also has vascular protective effect

Decreases gluconeogenesis and increases lipid oxidation in muscle
- negatively correlated with obesity

A

Adiponectin

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6
Q

Pickwickian syndrome is made up of what 2 breathing diseases
- often seen in obese patients

A

OHS and OSA

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7
Q

Higher the visceral fat, the less glucose disposal occurs which leads to..

A

Insulin resistance (glucose intolerance)

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8
Q

Last CV consequence of obesity (not CHF)

- occurs d/t increased pressure on LV

A

Concentric LVH

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9
Q

Deposition of fat in non-adipose tissue
- occurs when adipose depots are unable to adequately accommodate continued excessive caloric intake

Most commonly occurs in the:

  • pancreas
  • skeletal muscle
  • heart
  • liver

Detected by MRI

A

Ectopic adipose

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10
Q

End result of chronic and persistent abnormal cardiac loading

A

CHF

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11
Q

Volume of visceral adipose tissue is indirectly measured by obtaining a __

A

Waist circumference

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12
Q

Risk factor for:

  • CAD
  • HTN
  • Stroke
  • CHF
  • A-Fib
A

Obesity

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13
Q

Pathophysiology of __-induced hypertension results from underlying:

  • hemodynamic alteration - expansion of extracellular water and blood volume
  • renal dysfunction - increased tubular Na+ reabsorption
  • increase in sympathetic nervous system activity - d/t insulin resistance
  • activation of RAS
A

obesity

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14
Q

Leads to hypertriglyceridemia by stimulating lipolysis and hepatic TG secretion

A

IL-6

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15
Q

Relationship b/w deteriorating glucose disposal and body fat is directly correlated with …

A

Visceral adipose tissue

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16
Q

These are secreted factors from adipose tissue that include:

  • leptin
  • IL-6
  • TNF-alpha
  • plasminogen activator inhibitor 1 (PAI-1)
  • Angiotensinogen
A

Adipokines

17
Q

With advancing severity and duration of obesity, ventilatory insufficiency may develop as evidenced by progressive hypercapnia, hypoxemia, and polycythemia

This condition is called..

A

Obesity hypoventilation syndrome (OHS)

18
Q

Criteria for __ __: (need 3 for diagnosis)

  1. Elevated waist circumference (>40 for men, >35 for women)
  2. Elevated triglycerides (>150)
  3. Reduced HDL-C (<40 for men, <50 for women)
  4. Elevated BP
  5. Elevated fasting glucose
A

Metabolic Syndrome

19
Q

Pulmonary function aspect that is the most affected by obesity
- decreases d/t lack of ability of diaphragm to move as much as it should

A

Functional reserve capacity

20
Q

Increased energy expenditure and subsequent heat production coupled with redundant fat folds may lead to excessive __ and __ __

A

Diaphoresis

Skin infections

21
Q

Excessive accumulation of water and hemodynamic changes may lead to __ and __ __ of the legs

A

Edema

Stasis pigmentation

22
Q

Precedes the development of other components of metabolic syndrome

A

Central obesity

23
Q

Key studies have demonstrated a positive curvilinear relationship b/w __ and __ __
- begins to plateau at more severe levels of obesity

A

BMI

Insulin resistance

24
Q

Two factors intricately linked in the pathogenesis of the metabolic syndrome

A

Obesity

Insulin resistance

25
Q

2 adipokines that lead to insulin resistance that eventually leads to atherosclerosis

A

IL-6 and TNF-alpha

26
Q

Obesity increases risk of __ d/t left atrium starting to stretch so wide that it causes this disorder

A

A-Fib

27
Q

Obesity is associated with reduced:

  • functional residual capacity (FRC)
  • end-expiratory reserve volume (ERV)
  • Vital capacity (VC)
  • compliance of the lung and chest wall

These changes increase the __ __ of breathing

A

Mechanical work

28
Q

Most of the action of lipotoxicity comes from __ __

A

Visceral fat

29
Q

__ have a higher percentage of body fat

- leptin will be higher in these individuals as well

A

Women

30
Q

Thought of initially as only a storage site, but functions as an endocrine organ

A

Adipose tissue

31
Q

Gold standard techniques to define obesity in a pt

A

DXA and Air displacement plethysomography

32
Q

Increased fat depositions adjacent to the pharyngeal airway causes increased upper airway resistance and temporary cessation of airflow during sleep

Results in recurrent episodes of apnea and hypopnea, brief awakenings from sleep, and sleep disruption

Experiences daytime hypersomnolence

A

Obstructive sleep apnea

Endocrine (26 decks)

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