Energy Balance/Surgical Anatomy Flashcards
What percentage of energy for basal metabolism?
65-75%
What percentage of energy for activity?
10-15%
What percentage of energy for thermogenesis?
15-20%
What is the gold standard for measuring energy expenditure?
double labeled water
O2-18 lost as water and CO2
deuterium is ONLY water lost
what happened to rats who were force fed then stopped and allowed to eat normally?
lost weight back to ‘set point’
MC4 Receptor deletion in mice does what?
obese mice
what happens with increase energy intake?
more energy expenditure like fidgiting
eating is modulated by what centre?
pleasure centres
hypothalamus
What does cocaine and amphetamine do to appetite?
inhibit
What happened to mice with deleted orexin when they tested for hunger?
mice had narcolepsy
What does aMSH do to appetite besides maing you pigmented?
inhibits appetite
what happens to appetite when you damage the hypothalamus with a tumour removal for example?
could develop uncontrolled hunger: hypothalamic obesity
hypothalamic weight regulating mechanism responds to 3 tings:
higher coritcal centres
size of fat stores
food in gut
When ob mouse was attached to control what happened?
control mouse’s leptin came in and made ob mouse skinny
leptin receptor mutation does what to attached control mouse?
the excess leptin from the diabetic mouse went into control and died cause of no appetite
leptin synthesized by which cells?
adipocytes
where is leptin brain receptor?
choroid plexus
Leptin signals what?
size of fat stores
more fat in the cell = more/less leptin released?
more
will you always lose weight if you give more leptin?
not necessarily, could have leptin resistance from polymorphisms
insulin is long or short term?
long term
insulin in brain =
weight loss
insulin in body =
makes you hungry/gain weight
is liver sensitive to insulin?
yes, VERY.
glucose metabolism inhibits or enhances food intake?
inhibits
what do long chain fatty acids-CoA (LCFA-CoA) do?
inhibit food intake
Malonyl-CoA does what?
inhibits CPT1 which is needed for LCFA-CoA metabolism so you gain weight
obesity: how much is genes? how much is environment?
70% genes
30% environment
Common hormone mutation problems for obesity? 3 things
Leptin deficiency
Leptin receptor/signalling
decreases MSH
does diet early in life affect obesity in future?
YES. children get imprinted with high or low energy diet and even if they get healthy diet later, they will gain weight
3 likely endocrine causes of weight loss:
DM1
thyrotoxicosis
addison’s Disease (cortisol lack)
4 GI causes of weight loss:
chronic pancreatitis
CF
inflammatory bowel
parasitic infection
4 infective causes of weight loss?
TB
subacute bacterial endocarditis
amoebic abscess
HIV
5 malignant causes of weight loss:
bowel pancreas liver lymphoma leukaemia
Anorexia Nervosa onset is when?
before 25
Hallmark of Anorexia Nervosa?
distorted body image
4 medical complications of Anorexia Nervosa?
amenorrhoea
lanugo hair
bradycardia
anaemia
serotonin 1D and opioid delta receptor on chromosome 1 linked to?
Anorexia Nervosa
5-HT2A receptor is linked to?
Anorexia Nervosa
one study concluded ___% of variance in liability to Anorexia Nervosa could be genes.
80%
sliding hernia is?
part of stomach above diaphragm
what is rolling paraesophageal hernia?
sphincter intact, part of side of stomach above diaphragm
what is volvulus hernia?
twisted stomach
what is achalasia?
lower esophageal sphincter fails to relax due to abnormal peristalsis
2 things that cause small bowel obstruction?
adhesions
herniae
what is ileal pouch operation?
small bowel is connected to rectum after removal of colon
What is Meckel’s diverticulum?
congenital small intestine bulge: vestige of yolk stalk: 2% of pop
how many people will get colorectal cancer?
1:20
ventral herniae usually cause by?
incisional
underlying viscera due to bowel obstruction/strangulation
two types of groin herniae:
inguinal: direct/indirect more men
femoral: high risk more women
