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T2 - Phase 3 - Brain, Mind, and Behavior > BMB 3 - Disorders of Eating & Sleep > Flashcards

BMB 3 - Disorders of Eating & Sleep Flashcards

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1
Q

Which is the most dangerous (yet rare) eating disorder?

A

Anorexia nervosa

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2
Q

What disorder is characterized by a deliberate reduction in body mass as measured by BMI?

(Also, it may be induced by food restriction or binge-eating/purging.)

A

Anorexia nervosa

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3
Q

Anorexia nervosa is characterized by the refusal to maintain a body weight at or above _____% of expected weight.

A

Anorexia nervosa is characterized by the refusal to maintain a body weight at or above 85 % of expected weight.

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4
Q

Name some psychological disturbances that are features of anorexia nervosa.

A

Fear of gaining weight;

body image disturbance;

lack of awareness of the seriousness of low body weight

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5
Q

True/False.

The low nutrient scenario associated with anorexia nervosa can damage white matter tracks of the brain, decrease bone stability, and induce electrolyte abnormalities

A

True.

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6
Q

What is the basis of treatment for anorexia nervosa?

A

Psychotherapy and nutritional support

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7
Q

Although not totally effective, what medication is used as an adjuvant for treating anorexia nervosa?

A

SSRIs

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8
Q

One should be wary of what problem while treating anorexia nervosa?

A

Refeeding syndrome

(When one ingests too much food or liquid nutritional supplement during the initial four to seven days following a malnutrition event, the production of glycogen, fat and protein in cells may cause low concentrations of serum potassium, magnesium and phosphorus.)

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9
Q

Refeeding syndrome is characterized by low serum concentrations of what?

A

Potassium, magnesium and phosphorus

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10
Q

A patient who is not underweight experiences recurrent episodes of binge eating followed by compulsive behavior to counteract weight gain.

Is this anorexia nervosa?

A

No

(Bullemia nervosa)

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11
Q

Give some examples of weight loss strategies sometimes utilized in bullemia nervosa.

A

Vomiting,

laxative abuse,

starvation,

exercise

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12
Q

Bullemia nervosa is characterized by binge episodes and compulsive weight loss in episodes that occur ≥ __x every week for ≥ _________.

A

Bullemia nervosa is characterized by binge episodes and compulsive weight loss in episodes that occur ≥ 1 x every week for ≥ 3 months.

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13
Q

Patients with bullemia nervosa is often characterized by puffiness (fluid retention activated), dental caries, esophageal erosion, parotitis (‘_________ cheeks’), and callouses on knuckles (_________’s sign).

A

Patients with bullemia nervosa is often characterized by puffiness (fluid retention activated), dental caries, esophageal erosion, parotitis (‘chipmunk cheeks’), and callouses on knuckles (Russell’s sign).

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14
Q

Name some of the physical characteristics often seen in patients with bullemia nervosa.

A

Dental carries,

parotitis,

esophageal lacerations,

calluses on knuckles.

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15
Q

What is the BMI/weight likely to be in a patient with bullemia nervosa?

A

Normal or slightly elevated

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16
Q

What is the basis of treatment for bullemia nervosa?

A

Psychotherapy and nutritional support

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17
Q

Although not totally effective, what medications can be used as adjuvants for treating bullemia nervosa?

A

SSRIs

Topiramate

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18
Q

A patient who is not underweight experiences recurrent episodes of binge eating and a lack of perceived control over food intake (but no purging activities).

Is this bullemia nervosa?

A

No

(Binge eating disorder)

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19
Q

Binge eating disorder is characterized by binge episodes and compulsive weight loss in episodes that occur ≥ __x every week for ≥ _________.

A

Binge eating disorder is characterized by binge episodes and compulsive weight loss in episodes that occur ≥ 1 x every week for ≥ 3 months.

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20
Q

Treatment for binge eating disorder includes psychotherapy (CBT) with adjuvant use of what medication(s)?

A

SSRIs,

lisdexamfetamine,

or topiramate

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21
Q

What disorder is characterized by one with an appetite for and ingestion of nonnutritive substances?

A

Pica

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22
Q

Pica is most commonly seen in what populations?

A

Children or pregnant women

(eating sticks, rocks, sand, or something else that is not normal)

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23
Q

True/False.

Nearly all patients with eating disorders are very aware of their disorder and actively seek medical intervention.

A

False.

Patients with eating disorders often hide or protect their disorder.

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24
Q

Which brain nuclei are largely the main ‘internal clock’ maintaining our circadian rhythyms?

A

The suprachiasmatic nuclei

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25
Q

The most important cue for the circadian clock Is the ____________.

A

The most important cue for the circadian clock Is the environment.

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26
Q

What does the pineal gland produce and when?

A

Melatonin;

during darkness

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27
Q

True/False.

Darkness is not necessary for the melatonin signal, but sleep is.

A

False.

Sleep is not necessary for the melatonin signal, but darkness is.

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28
Q

Which organ is the main source of melatonin production?

A

The pineal gland

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29
Q

When influenced by external cues, an active, self-sustained oscillator (e.g. the suprachiasmatic nuclei) is known as a(n) ______________ circuit.

When not influenced by external cues, an active, self-sustained oscillator (e.g. the suprachiasmatic nuclei) is known as a(n) ______________ circuit.

A

When influenced by external cues, an active, self-sustained oscillator (e.g. the suprachiasmatic nuclei) is known as an entrained (synchronized) rhythm circuit.

When not influenced by external cues, an active, self-sustained oscillator (e.g. the suprachiasmatic nuclei) is known as a free-running rhythm circuit.

30
Q

The peak of a circadian rhythm is known as the what?

A

The acrophase

31
Q

The time between circadian rhythm peaks (or troughs) is known as the what?

A

A period (tau)

32
Q

A particular point in a circadian rhythm is known as the what?

A

A phase

33
Q

The distance between a peak and a trough within a graphed circadian rhythm is known as the what?

A

The amplitude

34
Q

What term refers to a circadian rhythm peak occuring earlier than expected?

A

Phase advance

35
Q

What term refers to a circadian rhythm peak occuring later than expected?

A

Phase delay

36
Q

Phase shifts (i.e. advance or delay) in circadian rhythms are typically seen when?

A

In sleep disorders

37
Q

Where do the suprachiasmatic nuclei receive information about light/dark cycles?

A

The optic nerves

38
Q

Our circadian rhythms are tuned to react to what wavelengths?

A

460 - 480 nm

(blue light)

39
Q

True/False.

Red light has little-to-no effect on our circadian rhythms.

A

True.

40
Q

A small population of retinal ganglion cells (~__%) are photoreceptors, aka _____________________________ (IPRGCs).

A

A small population of retinal ganglion cells (~ 1 %) are photoreceptors, aka intrinsically photoreceptive retinal ganglion cells (IPRGCs).

41
Q

What do intrinsically photoreceptive retinal ganglion cells (IPRGCs) contain instead of rhodopsin?

A

Melanopsin

(a blue light pigment)

42
Q

What are the two major drivers of the sleep/wake cycle?

A

Process S (homeostatic sleep drive)

Process C (circadian drive for arousal)

43
Q

Describe the basics of process S (homeostatic sleep drive) and process C (circadian drive for arousal) of the sleep/wake cycle.

A

Process S (homeostatic sleep drive) - homeostatic urges to rest that build up as the day goes on and cause sleepiness

Process C (circadian drive for arousal) - stimulation of the suprachiasmatic nuclei by blue light increases arousal

44
Q

What bedtime interplay between processes C and S is known as the sleep gate and is the time when one transitions from consciousness to sleep?

A

At bedtime, your homeostatic sleep drive (process S) is at its peak and your circadian drive for arousal drops off as light input decreases (process C)

45
Q

True/False.

Misalignment between process S and process C can cause sleep disturbance.

A

True.

46
Q

What is the technical term for preferring morning hours (being an early riser or ‘lark’ chronotype)?

A

Morning diurnal preference

47
Q

What is the technical term for preferring evening hours (being a late riser or ‘owl’ chronotype)?

A

Evening diurnal preference

48
Q

True/False.

One week of camping in natural light resets circadian clockworks, making ‘lark’ and ‘owl’ chronotypes more disparate.

A

False.

One week of camping in natural light resets circadian clockworks, making ‘lark’ and ‘owl’ chronotypes more alike.

49
Q

Identify the described sleep disorder type:

stable delay of the major sleep period by habitual onset and wake-up times several hours later relative to conventional and desired times.

A

Delayed sleep phase type

50
Q

Identify the described sleep disorder type:

stable advance of the major sleep period by habitual onset and wake-up times several hours earlier relative to conventional and desired times.

A

Advanced sleep phase type

51
Q

Identify the described sleep disorder type:

steady drift of the major sleep period by 1-2 hours each day.

A

Non-entrained (aka free-running or “Non-24”) type

52
Q

Identify the described sleep disorder type:

Absence of a clear circadian rhythm of sleep/wake​.

A

Irregular sleep-wake type

53
Q

Identify the described sleep disorder type:

temporary misalignment between the circadian clock and external time caused by rapid travel across time zones.

A

Jetlag type

54
Q

Identify the described sleep disorder type:

circadian misalignment that occurs when shift workers attempt to sleep at unusual circadian times because they have exposure to light at night.

A

Shift work sleep type

55
Q

Some sleep disorders can be treated with light therapy:

A person with with a advanced sleep phase can be exposed to bright light ________________.

A person with with a delayed sleep phase can be exposed to bright light ________________.

A

Some sleep disorders can be treated with light therapy:

A person with with a advanced sleep phase can be exposed to bright light before bedtime.

A person with with a delayed sleep phase can be exposed to bright light when they wake up.

56
Q

Wakefulness, as it relates to circadian synchrony, corresponds with what factors? feeding and energy storage, and it relates to __________ as it corresponds with fasting and energy utilization.

A

Feeding and energy storage

57
Q

Sleep, as it relates to circadian synchrony, corresponds with what factors?

A

Fasting and energy utilization

58
Q

True/False.

Circadian asynchrony (e.g. due to shift work) can lead to altered metabolic phenotypes, due to sleep and circadian disruption.

A

True.

59
Q

What issues of sleep length and diet can disrupt the circadian clock?

A

Sleep deprivation, prolonged wakefulness, and a high-fat diet

60
Q

What organ inhibits the spontaneous production of melatonin by the pineal gland?

Via what substance?

A

The suprachiasmatic nuclei;

norepinephrine

(So, blue light hits your eye, the optic nerves stimulate the SCN, the SCN inhibits the pineal gland.)

61
Q

What is the melatonin burst like during the Summer months (short nights)?

A

Shorter melatonin burst

62
Q

What is the melatonin burst like during the Winter months (long nights)?

A

Longer melatonin bursts, but same amplitude

63
Q

Melatonin is derived from __________.

A

Melatonin is derived from tryptophan.

64
Q

Name the three intermediates between tryptophan and melatonin.

A

Tryptophan → 5-hydroxytryptophan → Serotonin → N-acetylserotonin → Melatonin

65
Q

What enzyme converts N-acetylserotonin to melatonin?

(NOTE: this is the rate-limiting step of melatonin production.)

A

N-acetyltransferase enzyme

66
Q

What is the rate-limiting step of melatonin production?

A

N-acetylserotonin to melatonin

67
Q

What substance gets us through the sleep gate and into sleep?

A

Melatonin

68
Q

True/False.

Melatonin is low in early childhood and increases as we age (causing sleep disturbances in the elderly).

A

False.

Melatonin is high in early childhood and decreases as we age.

69
Q

The G-lymphatic system removes metabolic waste (e.g. beta-amyloid) from CNS tissues during what time?

A

Sleep

70
Q

What cell type controls G-lymphatic system removal of metabolic waste (e.g. beta-amyloid) from CNS tissues?

A

Astrocytes

71
Q

What is the most current hypothesis for the reason that shift workers have a higher risk of developing breast and prostate cancer?

A

Melatonin has anti-cancer properties

(via direct inhibition of the growth, progression, and metastasis of cancer)

T2 - Phase 3 - Brain, Mind, and Behavior (43 decks)

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