Exam 1 Flashcards
obesity (definition)
BMI that exceeds 30 or caloric intake that exceeds expenditure
true or false
BMI factors in muscle mass
false
environmental factors that play a role in adiposity
globalization of processed foods urbanization media/culture health literacy / education fiscal policies
numerous genes interact to facilitate overweight/obesity when the environment is permissive
polygenic
hypothalamus receptors
Orexigenic
increase food intake
decreases metabolism
Anorexigenic
decrease food intake (satiety)
increase metabolism
appetite is regulated by ________________
they stimulate hunger and/or fullness
gut peptides or peripheral mediators
leptin
produced in fat cell
suppresses appetite
higher blood levels in obesity
Ghrelin
produced in stomach
stimulates appetite
higher blood levels in obesity
insulin
produced in pancreas
controls amount of glucose in the blood at any given moment
higher levels in obesity
Adiponectin
produced in visceral fat protective insulin sensitizing anti-inflammatory reduces atherosclerosis lower blood levels in obesity
Peptide YY
produced in intestines
decreases appetite
decreases gastric motility
lower blood levels in obesity
A1C
amount of hemoglobin carrying glucose
will test for diabetes. Tests last 2-3 months
functions of adipose tissue
insulation mechanical support heat generation central role in glucose/lipid metabolism contain a dense concentration of macrophages (40-50% vs 10%)
adipose tissue produces adipokines which are directly or indirectly responsible for ….
vascular tone endothelial function coagulation insulin sensitivity leptin sensitivity
visceral adipose tissue distribution
central
hypertrophy - enlarged/gorged fat cells
associated with disease
increased inflammation
peripheral adipose tissue distribution
subcutaneous
hyperplasia - normal lipid storage / increased number of fat cells
protective
seen more in women (until menopause)
true or false
obesity is a chronic state of inflammation
true
what happens with enlarged adipocytes
increased lipolysis secreting pro-inflammatory adipokines
adiposity is associated with many chronic conditions including _________________
metabolic syndrome
Metabolic syndrom (definition)
a cluster of conditions that occur together, increasing the risk of heart disease, stroke and type 2 diabetes
traits that put at risk for metabolic syndrome
waist circumference > 40 in men and > 35 in women
blood pressure > 130/85
serum glucose > 100 mg/dl fasting
serum triglycerides > 150 mg/dl
serum high density lipoprotein < 40-50 mg/dl
true or false
altered adipocytes produce a tumor-promoting environment that leads to tumor progression and invasiveness
true
true or false
obesity is considered a positive comorbidity with the prognosis of some cancers
false
is is a negative comorbidity. a prognosis is worse if you are obese
thyroid hormones bind to receptors that are then responsible for __________ & ___________
protein synthesis and gene transcription
metabolic effects of thyroid hormones
increased basal metabolism increased Gluconeogenesis increased oxygen consumption increased lipolysis increased protein synthesis increased glucose absorption
cardiac effects of thyroid hormones
increased Chronotropic (heart rate) increased Inotropy (cardiac contractions or stroke volume, contractility) increased cardiac output
thyroid function (process)
hypothalamus releases thyrotropin releasing hormone (TRH) which stimulates the anterior pituitary to release thyroid stimulating hormone (TSH) which stimulates thyroid gland to release T3 (triiodothyronine) & T4 (thyroxine)
elevated blood levels of T3 and T4
increased cell metabolism
increased body temperature
negative feedback to hypothalamus & pituitary
Graves Disease
HYPERthyroidism
Auto-immune disease Type II
anti-body mediated mechanism
autoantibodies mimic TSH causing hyperplasia of thyroid gland-over produce thyroid Hormone (TH)
hyperthyroidism symptoms
excitability, nervousness intolerance to heat diaphoresis weight loss diarrhea muscle weakness extreme fatigue insomnia hand tremors Exophthalmos
Hashimoto’s Thyroiditis
HYPOthyroidism
autoimmune disease Type IV
antibody & cell-mediated mechanisms
autoantibodies & T cells destroy thyroid tissue
hypothyroidism symptoms
fatigue mental sluggishness bradycardia weight gain constipation hair loss, coarse hair scaly skin husky voice periorbital edema Dyslipidemia/CAD depression
lab values
hyperthyroidism
primary
increased thyroxine
decreased TSH
secondary (not common)
increased thyroxine
increased TSH
lab values
hypothyroidism
primary (most common)
decrease thyroxine
increased TSH
secondary
decreased thyroxine
decreased TSH
Iodine deficiency leads to ___________
hypothyroidism
Goiter
visible enlargement of thyroid gland due to hyperplasia
can compromise airway and interfere with swallowing
occurs in both hyper/hypo
Iodine deficiency clinical manifestations
hypothyroidism
goiter
pregnancy and fetal development
iodine deficiency prevention
iodized salt
iodine deficiency is
Most prevalent (but preventable) cause of brain damage
