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Gastroenterology > Appetite > Flashcards

Appetite Flashcards

1
Q

what is the most potent stimulus of thirst?

A

plasma osmolality increase

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2
Q

what are less potent stimuli of thirst?

A

blood volume reduction

blood pressure reduction

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3
Q

what hormone is important for the regulation of osmolality?

A

ADH (vasopressin)

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4
Q

main physiological action of ADH

A

acts on kidneys to transport aquaporin 2 channels to the collecting duct membrane > reabsorption of water

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5
Q

low plasma ADH produces what urine?

A

large, dilute volumes

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6
Q

high plasma ADH produces what urine?

A

small, concentrated volumes

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7
Q

where in the hypothalamus are osmoreceptors found?

A

subfornical organs

organum vasculosum of the lamina terminalis

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8
Q

osmoreceptor response to more concentrated plasma

A

cells shrink > ^proportion of cation channels > membrane depolarises > sends signals to ^ADH > fluid retention, invokes drinking
AND VICE VERSA

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9
Q

when is thirst decreased after drinking?

A

decreased even before sufficient water has been absorbed by the GI tract to correct plasma osmolality

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10
Q

receptors involved in thirst are found where?

A

mouth
pharynx
oesophagus

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11
Q

is relief of thirst sensation via receptors in the mouth, pharynx, oesophagus short lived or long acting?

A

short lived

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12
Q

when is thirst completely satisfied?

A

once plasma osmolality is decreased or blood volume or arterial pressure corrected

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13
Q

effect of RAAS on blood pressure/volume

A

angiotensin II > ADH secretion, vasoconstriction, ^ sympathetic activity, thirst, (aldosterone release > H20 retention via electrolytes)

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14
Q

aldosterone is released from where?

A

zona glomerulosa of adrenal cortex

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15
Q

effect of aldosterone on electrolytes

A

Na+ absorption

K+ excretion

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16
Q

effects of a reduction in fat mass

A

increases food intake and reduces energy expenditure

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17
Q

effects of adipose tissue expansion

A

reduces food intake and increases energy expenditure

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18
Q

what mechanism defends against reduction of body fat?

A

central circuit

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19
Q

what molecules/hormones are involved in appetite regulation?

A

ghrelin
PYY
gut hormones
leptin

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20
Q

briefly outline the structures of the hypothalamus

A

arcuate nucleus
paraventricular nucleus
lateral hypothalamus
ventromedial hypothalamus

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21
Q

what is the arcuate nucleus involved in?

A

regulation of food intake

22
Q

how does the arcuate nucleus have access to peripheral hormones?

A

incomplete blood brain barrier

23
Q

the arcuate nucleus has what two neuronal populations?

A

Stimulatory (NPY/Agrp neuron)

Inhibitory (POMC neuron)

24
Q

neurons in the arcuate nucleus give feedback to?

A

paraventricular nucleus

25
Q

the melanocortin system

A

POMC > alpha-MSH > MC4R

Agrp >Agrp > MC4R

26
Q

what human CNS mutation affect appetite?

A

POMC deficiency

MC4-R mutation

27
Q

what signals from other brain regions affect appetite?

A

higher centres
amygdala
other parts of hypothalamus e.g. lateral hypothalamus
vagus > brain stem > hypothalamus

28
Q

adipostat mechanism

A

circulating hormone produced by fat > sensed by hypothalamus > alter neuropeptides to increase or decrease food intake

29
Q

where is leptin made?

A

adipocytes in white adipose tissue

30
Q

main physiological actions of leptin

A

acts on hypothalamus regulating appetite (intake)

thermogenesis (expenditure)

31
Q

what is condition involving leptin?

A

congenital leptin deficiency

32
Q

mechanism of action of leptin

A

leptin > receptor (LRb) in the brain > regulate energy balance and neuroendocrine function. LRb signaling via STAT3 and a number of other pathways is required for the totality of leptin action.

33
Q

levels of leptin when body fat is low

A

low

34
Q

levels of leptin when body fat is high

A

high

35
Q

leptin in obesity

A

leptin resistance > hormone is present but doesn’t signal effectively

36
Q

is leptin a viable weight control drug?

A

no, ineffective

37
Q

GI hormones are secreted from?

A

enteroendocrine cell in the stomach, pancreas and small bowel

38
Q

list GI hormones that regulate appetite

A

Ghrelin

Peptide YY

39
Q

effect of ghrelin

A

stimulates appetite

increases gastric emptying

40
Q

effect of peptide YY

A

inhibits food intake

41
Q

when are blood levels of ghrelin highest?

A

before meals

42
Q

how does ghrelin help prepare for food intake?

A

increases gastric motility

increases acid secretion

43
Q

effect of ghrelin on neurons in arcuate nucleus

A

stimulates NPY/Agrp neurons

inhibits POMC neurons

44
Q

apart from appetite regulation, ghrelin has a role in?

A

regulation of reward
taste sensation
memory
circadian rhythm

45
Q

PYY is released from?

A

terminal ileum

colon

46
Q

PYY is released in response to?

A

in response to feeding

47
Q

effects on PYY

A

reduces appetite

48
Q

PYY inhibits what?

A

inhibits NPY release

49
Q

PYY has what effect on neurons in the arcuate nucleus?

A

stimulates POMC neurons

50
Q

obesity is associated with what comorbidities?

A

depression, stroke, sleep apnoea, MI, hypertension, diabetes, bowel cancer, osteoarthritis, peripheral vascular disease, gout

51
Q

describe the global trend of obesity and related comorbidities

A

increasing worldwide

Gastroenterology (9 decks)

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