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BRS 4 Endocrinology > 1b Obesity > Flashcards

1b Obesity Flashcards

1
Q

What is obesity?

A

A condition of abnormal or excessive fat accumulation in adipose tissue, due to the extent that health is impaired

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2
Q

What is the BMI range for obesity?

A

BMI > 30

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3
Q

How do you calculate BMI?

A

weiht in kg / height in m squared

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4
Q

What factors are not taken to account in BMI calculations that can make the result misleading?

A

Body muscle
Body fat percentage
Body fat distribution
Different demographics

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5
Q

What are some factors which can influence obesity?

A

Environment
Genetics
Ability to play outside
Car use
Screen time
Education Level
Educational achievement
Poverty
Social Deprivation

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6
Q

What are the co-morbitidies associated with obesity?

A

Stroke
Depression
MI
Sleep apnoea
Bowel cancer
Diabetes
Hypertension
OA
Gout

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7
Q

What single gene mutation is most likely to cause obesity?

A

Melanocortin 4 receptor genes

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8
Q

What is leptin resistance?

A

In some obese people,the brain does not respond to leptin, so they keep eating despite adequate (or excessive) fat stores, a concept known as ‘leptin resistance’

This causes the fat cells to produce even more leptin.

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9
Q

Describe the symptoms associated with leptin deficiency?

A

Infertility
Stunted growth
Decreased body temperature
Decreased energy expenditure
Decreased immune function

The body thinks it is in a starving state, and therefore does not waste energy on other body functions as listed above

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10
Q

Describe the physiological functions of leptin?

A

Helps regulate thyroid hormone synthesis
Increases heart rate
Decreases glucose-stimulated insulin release
regulates bone mass
regulates the menstrual cycle
Activates immune cells
INcreases blood pressure
Regulates appetite and controls metabolism

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11
Q

Describe the effects seen when children with leptin deficiency receive recombinant leptin therapy?

A

Body weight reduction

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12
Q

Describe the effects of leptin therapy on LH and FSH secretion?

A

Restores the pulsatile secretion patterns

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13
Q

What is leptin?

A

An anti-starvation hormone

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14
Q

What does the presence of leptin suggest to the brain?

A

Signal that the system has sufficient fat reserves for normal functioning but HIGH LEPTIN HAS LITTLE EFFECT

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15
Q

What drug can you use as a treatment for obesity?

A

ORLISTAT

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16
Q

What is Orlistat?

A

Derivative of an endogenous lipstatin produced by Streptomyces toxytricini

Gastric and pancreatic lipase inhibitor therefore it stops fat digestion directly in turn reducing absorption

17
Q

What type of drug is Liraglutide / Saxenda?

A

Long acting glucagon like peptide-1 receptor agonist - daily injection

18
Q

What other gut hormone can be targetted in the treatment of diabetes?

A

GLP-1

19
Q

What are the three conditions in which you should consider Bariatric Surgery?

A
  1. BMI of 40>
  2. BMI of 35-50 and other co-morbidities
  3. BMI or 30-35 for newly diagnosed T2DM
20
Q

What are the three types of Bariatric Surgery?

A
  1. Gastric Bypass
  2. Gastric Band
  3. Sleeve gastrectomy
21
Q

What does a gastric bypass involve?

A

Top part of the stomach is joined to the small intestine so you feel fuller sooner and do not absorb as many calories

22
Q

What is a gastric band surgery?

A

Band placed around the stomach so you do not need to eat as much to feel full

23
Q

What is a sleeve gastrectomy?

A

Some of the stomach is removed so cannot eat as much

24
Q

What is Tirzepatide?

A

Long acting glucagon like peptide 1 receptor and glucose dependant insulinotrophic polypeptide receptor co-agonist

25
Q

Which type of bariatric surgery has the most effect on weight change?

A

Gastric Bypass - long term as well

26
Q

List the things you need to check before a patient can have bariatric surgery.

A

Non-surgical measures have failed to achieve or maintainadequate clinically beneficial weight loss for at least 6 months

Receiving or will receive intensive specialist management

Generally fit for anaesthesia and surgery

Commit to the need for long-term follow-up.

BRS 4 Endocrinology (20 decks)

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