Disorders of Appetite

Question 1

What is polydipsia?

Answer 1

excessive thirst or excess drinking

Question 2

What is adipsia?

Answer 2

inappropriate lack of thirst

Question 3

What is anorexia?

Answer 3

lack or loss of appetite for food

Question 4

What is obesity?

Answer 4

abnormal or excessive fat accumulation that presents as a risk to health

Question 5

What is secondary polydipsia?

Answer 5

medical issue disrupting osmoregulation or alteration in ADH function leading to polydipsia

Question 6

What are causes of secondary polydipsia?

Answer 6

chronic medical conditions ie kidney failure, addisions, diabetes insipidus and mellitus

medications, such as laxatives and diuretics

dehydration from acute illness, sweating, fevers

Question 7

How can we treat diabetes insipidus?

Answer 7

with desmopressin

Question 8

What are pathophysiological causes of diabetes insipidus?

Answer 8

Pituitary gland not producing ADH or kidneys being desensitised to ADH

Question 9

What are symptoms of diabetes?

Answer 9

tiredness, frequent urination, hunger, blurry vision, numb or tingling hands or feet, always thirsty, sexual problems, vaginal infections, weight loss, wounds that do not heal etc

Question 10

What other medical conditions can lead to polydipsia?

Answer 10

acute kidney disease
conns syndrome
addisons disease

Question 11

What is conns disease?

Answer 11

Primary aldosteronism - over production of aldosterone

Question 12

What addison’s disease?

Answer 12

HYPOadrenocorticism

Question 13

What is primary polydipsia?

Answer 13

excess consumption of water usually due to mental illness (psychogenic polydipsia)

Question 14

What are causes of primary polydipsia?

Answer 14

mental illness ie schizophrenia, anorexia, drug use

brain injuries
organic brain damage

Question 15

Why is polydipsia a problem?

Answer 15

can cause:
kidney and bone damage
nausea
headache
cramps
slow reflexes
slurred speech 
low energy 
confusion 
seizures

Question 16

What are the types of adipsia?

Answer 16

type A, B, C, D

Question 17

Outline the physiology behind adipsia?

Answer 17

increased osmolality of urine -> stimulates secretion of adh -> leads to water retention -> sensation of thirst decreases

Question 18

What are examples of common eating disorders?

Answer 18

binge eating disorder
anorexia nervosa
bulimia nervosa
pica
rumination syndrome
avoidant restrictive food intake disorder

Question 19

What are the BMI classifications for anorexia nervosa?

Answer 19

mild - BMI >17
moderate - BMI 16-16.99
severe - BMI 15-15.99
extreme - BMI<15

Question 20

What are the signs of anorexia?

Answer 20

low BMI, continuous weight loss, amenorrhea, halitosis, mood swings, dry hair, skin and hair thinning

Question 21

What are the causes of anorexia?

Answer 21

combination genetic, environmental, psychological and sociological factors

Question 22

What are the BMI classifications for obesity?

Answer 22

bmi or >30 or >25 with a comorbidity

Question 23

How do we treat obesity?

Answer 23

lifestyle modification - diet + exercise

Question 24

What are surgical treatment options of obesity?

Answer 24

BMI >40

commonly roux en Y gastric bypass and sleeve gastrectomy

Question 25

What is the physiological background of bariatric surgery?

Answer 25

GLP1 and GLP2 - stimulates insulin release and inhibits glucagon release

ghrelin - hunger hormone -> lead to NPY activation and initiate appetite

PYY - feelings of satiety and is anorexogenic

Question 26

How do gut hormones change after bariatric surgery?

Answer 26

ghrelin reduces - less appetite

increases in CCK

GLP1 and GLP2, PYY elevated

Question 27

What is the action of GLP-1?

Answer 27

increase beta cell function - more insulin
increase hypoglycemia

also leads to more insulin sensitivity, weight loss, and more bile acid secretion