Disorders of Appetite (Complete) Flashcards by Sydney Carrera-Brown

Food intake is interchangeable with what other term?

Appetite

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water intake is interchangeable with what other term?

Thirst

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Excessive thirst or excessive drinking is known as?

Polydipsia

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Inappropriate lack of thirst is known as?

(with consequent failure to drink in order to correct hyperosmolality)

Adipsia

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Lack or loss of appetite for food is known as?

Anorexia

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Define obesity

Abnormal or excessive fat accumulation that presents a risk to health

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What are the two classification of disorders that can arise due to disturbance in regulation fo thirst?

Polydipsic disorders

Adipsic disorders

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What are the two types of polydpisic and adipsic disorders?

Primary

Secondary

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Which type of polydipisia is most common?

Secondary polydipsia

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Define secondary polydipsia.

Excessive thirst caused by medical issues that disrupt any step in osmoregulation or alter ADH

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List 5 examples of chronic conditions that can cause secondary polydipisa

Diabetes mellitus

Diabetes insipidus

Kidney failure

Conn’s syndrome (excessive aldosterone)

Addison’s disease (adrenal insufficiency)

Sickle cell aneamia

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List 5 examples of medications that can cause secondary polydipisa

Diuretics

Laxatives

Antidepressants

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List 6 examples of causes of dehydration which can lead to development of secondary polydipsia

Acute illness

Sweating

Fevers

Vomiting

Diarrhoea

Underhydration

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List some general symptoms/signs of diabetes mellitus

Always tired

Polydipsia

Polyuria

Nocturia

Wounds that wont heal

Sudden weight loss

Sexual problems

Increased appetite

Blurred visison

Numbness in hands and feet

Increased UT infections (e.g vaginal problems)

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What are the 3 main causes for primary polydipsia

Mental illness (e.g. psychogenic polydipsia)

Brain injuries

Organic brain damage

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List 5 examples of mental illnesses which can lead to primary polydipsia

Psychogenic polydipsia

Schizophrenia

Mood disorders - depression and anxiety

Anorexia

Drug use

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Polydipsia is quite problematic and can lead to a lot of further complications. List 9 potential consequences of polydipsia

Kidney and bone damage

Headache

Nausea

Cramps

Slow reflexes

Slurred speech

Low energy

Confusion

Seizures

(N.B. Quite a few due to electrolyte imbalances such as hyponatraemia)

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What are the types of adipsia? Which type is most common?

Type A (most common)

Type B

Type C

Typde D

What is the pathophysiology behind type A adipsia?

Type A is characterised by a higher osmotic threshold needed for activation of osmoreceptors which are responsible for feeling of thirst and vassopressing release

Explain how osmoreceptors play a role in ADH release

Cells shrink when plasma more concentrated

Proportion of cation channels increases – membrane depolarizes

Send signals to the ADH producing cells to increase ADH

Fluid retention then invokes drinking

Define eating disorder

Mental disorder defined by abnormal eating habits

List 6 examples of eating disorders

Binge eating disorder

Anorexia nervosa

Bulimia nervosa (Binge followed by purging)

Pica (compulsive eating of non-food items)

Rumination syndrome (regurgitation of food)

Avoidant/restrictive food intake disorder (picky eating/reduced want of food intake)

How has the prevalence of eating disorders changed over the years?

prevalence ↑ed from 3.4% to 7.8% between 2000 and 2018.

70 million people live with eating disorder

List 7 signs of anorexia

Low BMI

continuous weight loss

Amenorrhea

Halitosis (bad breath)

Mood swings

Dry hair

Skin & hair thinning

List 4 causes of anorexia

Genetic Environmental Psychological Sociological

What BMI ranges are indicative of the different severities of anorexia? Mild, Moderate, Severe, Extreme

Mild: BMI \> 17 Moderate: BMI of 16–16.99 Severe: BMI of 15–15.99 Extreme: BMI \< 15

What neurotransmitter, when at lower levels is associated with anorexia?

Seretonin

What is the main reason obesity levels have been increasing wowrldwide?

Cheap, calorie-rich/nutrient poor beverages, sweets and fast food. N.B. Contrary to popular belief it is not reduced levels of physical activity (Physical activity started to decline prior to obesity epidemic)

What is the reccomended screening test for obesity?

BMI measurement

List the 3 components involved in obesity screening

Height, Weight and abdominal girth measurements Medical history (Dietary and physical activity patterns, psychosocial factors, weight-gaining medications, familial traits) BMI calculation

What BMI criteria must be met to consider a person as being obese?

BMI _\>_ 30 kg/m² OR BMI ≥25 kg/m² + comorbidity or risk factor

What units does BMI use?

kg/m²

What are the 2 main lifestyle modifications shown to result in weight loss. Which one has the biggest factor in losing weight?

Exercise Diet Diet is biggest lifestyle modification

What combination of lifestyle modifications has been shown to have the largest effect on weight loss?

Diet + Exercise

What is the main treatment option for people with severe obesity (BMI \> 40 or 35 + comorbidities?

Bariatric Surgery (e.g. Roux-en-Y gastric bypass & sleeve gastrectomy)

There are multiple types of procedures under umbrella term of bariatric surgery. What is the most common type of bariatric surgery in treatment of obesity?

Roux-en-Y gastric bypass & sleeve gastrectomy Reduces stomach to size of an egg and leaves gastric remnant

What are the 2 main effects of bariatric surgery post op?

Weight loss 5 yrs after BS: 30% - 35% There is a reduction of all cause mortality & morbidity after BS

What two co-morbidities alongside obesity have been shown to result in remission?

Diabetes (80% of cases result in remission) OSA [Obstructive sleep apnoea] (80%-85%)

Breifly explain why bariatric surgery results in remission in severely obese patients with T2DM.

BS can increase endogenous production of GLP-1 nad GLP-2 Elevation can therefore result in increased release of insulin and reduction in glucagon release. This results in remission of diabetes as a result

Explain why bariatric surgery results in weight loss.

BS results in reduction of the stomach/bypass, resulting in less release of grehlin. Grehlin is the gut hormone responsible for inducing appetite through activation of NPY. BS also increases the release of PYY which is responsible for inducing satiety and has an anorexigenic effect. This ultimately results in reduced food intake and hence weight loss

What hormonal changes are induced after bariatric surgery?

Grehlin reduces (due to easier stomach filling) PYY, GLP-1 and GLP-2 increases

The release of grehlin is triggered by?

An empty stomach

When should surgical treatment for obesity be considered?

People with a \> BMI 40 or 35+ comorbidities (e.g. T2DM)

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Disorders of Appetite (Complete) Flashcards

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