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Patho 2 > 2 - Obesity and Nutrition > Flashcards

2 - Obesity and Nutrition Flashcards

1
Q

White adipose tissue (WAT) functions as a ______ organ

A

endocrine!

secretes adipokines that function like hormones with autocrine/paracrine/endocrine actions to refulate energy homeostasis

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2
Q

How is adipose tissue type classified?

A

by color

White (WAT)

Brown (BAT)

Beige (bAT)

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3
Q

Most adipose tissue is classified as:

A

WAT

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4
Q

Which is visceral WAT more likely to do if excess fat is generated:

hypertrophy or adipogenesis?

A

hypertrophy

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5
Q

Which subcutaneous fat more likely to do if excess fat is produced:

Adipogenesis or hypertrophy

A

adipogenesis

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6
Q

Which is harder on your body: hypertrophy or adipogenesis?

A

Hypertrophy

Adipogenesis leads to smaller adipocytes with greater fat storage capacity

Produces more leptin, less adiponecting, and fewer inflammatory mediators

Has a lower associated with insulin resistance

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7
Q

The complications of obesity are in large part due not just to the amount of fat in the body, but _______

A

where the fat is stored in the body

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8
Q

What effect does estrogen have on fat storage?

A

Enhances the deposition of fat in the SubQ tissue, inhibits it in visceral tissue

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9
Q

Why are premenopausal women more likely to have peripheral fat, while menopausal women and men are more likely to have visceral fat?

A

Estradiol increases alpha 2 adrenergic receptors in SQ tissue but not visceral

Alpha receptors outnumber beta receptors, so lipolysis is lower in SQ tissues

The reverse is true in the visceral tissue

hence, women with estradiol burn less SQ fat than visceral fat

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10
Q

Brown adipocytes have ______ vacuole(s)

White adipocytes have ______ vacuole(s)

A

multiple

one

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11
Q

Why are BAT brown?

A

Large numbers of mitochondria

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12
Q

Describe how BAT increases body heat

A

Activation of Uncoupling protein 1 (UPC1) promotes mitochondrial respiration

dissipates chemical energy as heat from increased flucose and FFA oxidation

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13
Q

What stimulates BAT heat generation?

A

exposure to cold

SNS

catecholamines

T3

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14
Q

How is BAT related to BMI and age

A

inversely

the higher the BMI, the less BAT

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15
Q

Production of bAT is called:

A

“the beiging of WAT”

Develops in response to chronic exposure to cold, with exercise

This is a reversible adaptation

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16
Q

Which brain nucleus regulates food intake and metabolism?

A

Arcuate (hypothalamus)

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17
Q

Neurons that promote appetite are called ______ neurons and are stimulated by ______

Neurons that inhibit appetite are called ______ neurons and are stimulated by _________

A

orexigenic

orexins

anorexigenic

anorexins

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18
Q

Leptin is a product of the _____ gene and is expressed by _____ cells

A

Ob

Adipocyte

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19
Q

High leptin levels inhibit ______ and stimulate _______

Low leptin levels inhibit _____ and stimulate _______

A

orexigenic, anorexic

anorexic, orexigenic

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20
Q

What is leptin resistance?

A

Leptin levels increase with the number of adipocytes, leading to downregulation of receptors

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21
Q

What does leptin resistance lead to?

A

Overeating

Hyperglycemia

Hyperinsulinemia

Hyperlipidemia

Inflammation

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22
Q

What all does leptin regulate?

A

Satiety

Hepatic gluconeogenesis

insulin sensitivity

glucose and lipid metabolism in the liver, muscles, and adipose tissue

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23
Q

Leptin resistance leads to ______ resistance

A

insulin

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24
Q

What is the role of adiponectin in obesity?

A

produced by visceral adipose, cardiomyocytes and skeletal muscle

insulin-sensitizing

anti-inflammatory

Plasma levels decrease with visceral obesity

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25
Q

Why is adiponecting made in cardiomyocytes?

A

It is cardioprotective

decreased levels associated with CAD

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26
Q

Where is Ghrelin produced?

What does it do?

A

In the stomach mucosa in response to hunger

stimulates food intake

induces metabolis changes leading to increased weight and fat mass

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27
Q

Ghrelin stimulates the release of ______ hormone

A

GH

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28
Q

What decreases Ghrelin levels?

A

Increased serum FFAs

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29
Q

How does obesity related to ghrelin?

A

Causes ghrelin resistance

In obese people, ghrelin does not decrease after eating. Instead, it stays at a steady elevated level, with only slight dips after meals

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30
Q

CCK levels are _____ in obesity

A

decreased

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31
Q

Obesity produces a chronic state of _____ in WAT

A

inflammation

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32
Q

What are other terms for visceral obesity?

A

intraabdominal

central

masculine

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33
Q

What are other terms for peripheral obesity?

A

subcutaneous

gluteal-femoral

feminine

34
Q

What is normal weight obesity?

A

Normal body weight and BMI with >30% body fat

35
Q

What is cachexia?

A

Cytokin-induced malnutrition

physical wasting

36
Q

What is refeeding syndrome?

A

In severely malnourished patients, their insulin levels are extremely low

In addition, their plasma levels of electrolytes plummet, so K/Mg/Phos move out of the cell and into the plasma

When feeding starts up again, the cells is hypersensitive to insulin, and starts sucking all those electrolytes back in

Can lead to perilously low blood levels

37
Q

How many calories are liberated from 1g of the following:

Carbohydrates

Fat

Proteins

A

4

9

4

38
Q

What are partial proteins?

A

Proteins that contain inadequate amounts of essential amino acids

39
Q

Proteins derived from meats are usually ______

Proteins derived from vegetables are usually _____

A

complete

less complete/partial

40
Q

In vegetarian diets, the combination of ______ and _____ provides all the essential amino acids

A

corn

legumes

41
Q

The respiratory quotient for carbs is 1

the respiratory quotient for fats is 0.7 and proteins are 0.8

Why?

A

When carbs are metabolized with oxygen, exactly one CO2 molecule is formed for every molecule of O2 consumed

for fat and proteins, a portion of the oxygen metabolised is required to combine with the excess hydrogen atoms, so less CO2 is produced

42
Q

Describe the respiratory quotient directly after a mixed meal?

8 hours later?

A

approaches one, as the body prioritizes carb metabolism

All the carbs have been used or stored, and respiratory quotient approaches 0.7 (fat metabolism)

43
Q

In severe diabetes, what would the respiratory quotient most likely be?

A

0.7, fat metabolism

44
Q

What percentage of the average protein is nitrogen?

A

16%

45
Q

What does it mean if someone has a negative nitrogen balance?

A

their body stores of protein are decreasing daily

46
Q

What percentage of ingested energy actually reaches the cells?

A

27%

47
Q

Which area in the brain contains the hunger and satiety centers?

A

The hypothalamus

48
Q

The _______ of the hypothalamus serve as a feeding center

A

lateral nuclei

49
Q

The ______ of the hypothalamus serves as a satiety center

A

ventromedial

inhibits the feeding center

50
Q

Destruction of the ventromedial nucleus of the hypothalamus would cause:

A

voracious eating, up to four times normal

51
Q

Are the following hormones anorexigenic or orexigenic?

Leptin

Serotonin

Cortisol

Insulin

CCK

Ghrelin

A

Leptin - Anorexigenic

Serotonin - Anorexigenic

Cortisol - Orexigenic

Insulin - Anorexigenic

CCK - Anorexigenic

Ghrelin - Orexigenic

52
Q

What suppresses appetite in the short term, preventing over eating?

A
  1. Gastrointestinal filling sends stretch receptors via the vagus to suppress feeding centers
  2. CCK activates receptors on local sensory nerves in the duodenuum, sends via the vagus
  3. Oral receptors meter food intake (less of an impact than GI filling)
53
Q

How does ghrelin affect feeding?

A

increases feeding

54
Q

How does the hypothalamus sense energy storage?

A

leptin produced by adipocytes

55
Q

Stimulation of leptin receptors in the CNS leads to:

A
  1. hypothalamus suppresses AGRP
  2. Hypothalamus stimulates POMC
  3. hypothalamus increases CRH
  4. decrease insulin secretion from pancreas
56
Q

What is the calculation for BMI?

A

kg/m2

57
Q

What kind of tumor is associated with progressive obesity?

A

hypophyseal tumor that encroach on the hypothalamus

58
Q

Naltrexone is used in conjunction with _______ to reduce obesity

A

buproprion

Crazy!

59
Q

what is inanition?

A

opposite of obesity

extreme weight loss

60
Q

What is a vitamin?

A

organic compound needed in small quantities for normal metabolism that can’t be manufactured in the cells of the body

61
Q

What disease is caused by thiamine deficiency?

A

Beriberi

62
Q

What is the pathogenesis of berberi?

A

thiamine deficiency caused decreased utilization of pyruvic acid and some amino acids by the tissues

increases utilization of fats

63
Q

What are the major effects of Beriberi?

A
  1. lesions of the CNS and PNS (the brain is using ketone bodies instead of glucose, which causes swelling and inflammation)
  2. cardiac failure and vasodilation
  3. indigestion, severe constipation, anorexia, gastric atony, hypochlorhydria
64
Q

Why is riboflavin’s big role in body?

A

Required in the electron transport chain

65
Q

Name the B Vitamins

A
  1. Thiamine
  2. Riboflavin
  3. Niacin
  4. Pantothenic Acid
  5. Pyridoxine
  6. Folic Acid
  7. B12
66
Q

What is the function of niacin in the body?

A

nicotinic acid

NAD and NADP -> ETC

67
Q

Niacin deficiency is called _____ and results in people on a ______ diet

A

pellagra

corn

(corn lacks tryptophan, which can be convertered to niacin)

68
Q

What is the role of Vitamin B5?

What does a deficiency cause

A

Pantothenic Acid = CoA

depressed metabolism of carbs and fats

69
Q

What is the role of pyroxidine in the body?

A

Vit B6

transaminatio of amino acids

70
Q

What does Vitamin B12 deficiency cause?

A

pernicious anemia

demyelination of the large nerve fibers in the spinal cord

71
Q

What are the major functions of B12 in the body?

A

reduces ribonucleotides to deoxyribonucleotides, facilitating gene replication

  1. promotion of growth
  2. promotion of RBC formation and maturation
72
Q

What is the role of Vitamin B9 in the body?

A

Folic Acid

synthesis of purines and thymine, which are required for DNA synthesis

73
Q

One of the most significant effects of Folic Acid deficiency is:

A

macrocytic anemia (almost identical to pernicious anemia)

74
Q

What are the consequences of a Vitamin C deficiency?

A

weakens collagen fibers

causes scurvy

75
Q

How long does it take to get scurvy?

A

20-30 weeks

76
Q

What are the effects of scurvy?

A

Fucked up collagen:

  1. failure of wounds to heal
  2. cessation of bone growth
  3. blood vessel walls become extremely fragile
77
Q

Vitamin E plays a protective role in the prevention of:

A

oxidation of unsaturated fats

78
Q

Where is vitamin k synthesized?

A

bacteria in the colon

79
Q

What usually causes Vit K deficiency?

A

problems with gut flora

almost never caused by a decreased intake

80
Q

______ is the major anion of intracellular fluid

A

phosphate

81
Q

Zinc is an integral part of which enzymes?

A

carbonic anhydrase

lactic dehydrogenase

82
Q

How does fluorine make teeth stronger

A

It doesn’t. It suppresses the cariogenic process.

Patho 2 (24 decks)

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