Disorders of Appetite Flashcards
What is water intake?
thirst
What is food intake?
appetite
What is polydypsia?
excessive thirst or excess drinking
What is adipsia?
inappropriate lack of thirst
- with consequent failure to drink in order to correct hyperosmolality
What is anorexia?
lack or loss of appetite for food
What is obesity?
abnormal or excessive fat accumulation that presents a risk to health
What are two types of poydypsia?
- Primary
2. Secondary
What is secondary polydypsia?
- More common
* Medical issues that disrupt any step in osmoregulation or alter ADH can cause secondary polydipsia
Where is ADH stored?
posterior pituitary
What is ADH?
- Antidiuretic hormone (ADH) or vasopressin
- Acts on the kidneys to regulate the volume & osmolality of urine
- Collecting duct - Aquaporin 2 channel
What happen when plasma ADH is low?
large volume of urine is excreted (water diuresis)
What happens when plasma ADH is high?
small volume of urine is excreted (anti diuresis
What are causes of secondary polydipsia?
- Chronic medical conditions
- Medications
- Dehydration
What are the chronic medical conditions that cause secondary polydipsia?
- Diabetes insipidus & mellitus
- Kidney failure
- Conn’s syndrome
- Addison’s disease
- Sickle cell anaemia
What are the medications that cause secondary polydipsia?
- Diuretics
- Laxatives
- Both result in dehydration
- Antidepressants
What are the dehyration that cause secondary polydipsia?
- Acute illness
- Sweating
- Fevers
- Vomiting
- Diarrhoea
- Underhydration
What diabetes insipidus (DI)?
•General population - uncommon
•Related to pituitary problems
•Impaired ADH production
Treatment with desmopressin
What is diabetes mellitus (DM)?
- General population - common
- Related to high blood sugar
- Treatment of high blood sugar
What are other medical conditions leading to polydipsia?
- Acute kidney failure
- Conn’s syndrome
- Primary aldosteronism - Addison’s disease
- Hypoadrenocorticism
What are the causes of primary polydipsia?
- Mental illness
- Brain injuries
- Organic brain damage
What are the mental health reasons for primary polydipsia?
- psychogenic polydipsia (or acquired)
- Schizophrenia
- Mood disorders - depressionandanxiety
- Anorexia
- drug use
What is polydypsia a problem?
- Kidney and bone damage
- Headache
- Nausea
- Cramps
- Slow reflexes
- Slurred speech
- Low energy
- Confusion
- Seizures
What are the different types of adipsia?
- Type A – most common
- Type B
- Type C
- Type D
What happens in adipsia?
- Increased osmolarity of urine
- Stimulates secretion of ADH
- Water retention
- Sensation of thirst decreases
What is an eating disorder?
Mental disorderdefined by abnormal eating habits, includes:
•Binge eating disorder
•Anorexia nervosa
•Bulimia nervosa
•Pica
•Rumination syndrome
•Avoidant/restrictive food intake disorder
How common are eating disorders?
- Global eating disorderprevalence ↑ed from 3.4% to 7.8% between 2000 and 2018.
- 70 million people live with eating disorder
What are the signs of anorexia?
Low BMI, continuous weight loss, amenorrhea, halitosis, mood swings, dry hair, skin & hair thinning
What are the causes of anorexia?
Genetic, environmental, psychological, sociological
What is the mechanism of anorexia?
seretonin
What are the classification of anorexia?
- Mild: BMI > 17
- Moderate: BMI of 16–16.99
- Severe: BMI of 15–15.99
- Extreme: BMI < 15
Why is obesity increasing?
cheap, calorie rich/ nutrient. poor beverages, sweets and fast food
What is involved in the screening of obesity?
- Height, weight and abdominal girth
- Medical history:
- Dietary and physical activity patterns, psychosocial factors, weight-gaining medications, familial traits - BMI = kg/m2
- BMI of ≥30 or ≥25 + comorbidity or risk factor
What is the treatment of obesity?
diet + exercise
When do people get surgical treatment of obesity?
- People with a > BMI 40 or 35+ comorbidities
* Various procedures
What is the most common type of surgical treatment of obesity?
- Most common Roux-en-Y gastric bypass & sleeve gastrectomy
- WL 5 yrs after BS: 30% - 35%
- Remission of comorbidities
- Diabetes (80%)
- OSA (80%-85%
What is GLP1 and GLP2 used for?
- Stimulate insulin release
* Inhibit glucagon release
What is ghrelin used for?
- Hunger hormone
* NPY activation – initiate appetite
What is PYY used for?
- Satiety
* anorexogenic
What are the hormonal changes after bariatric surgery?
- Chrelin reduces
2. GLP1 + GLP2 and PYY elevated
