Feb6 M2-Anorexia and Cachexia

Question 1

GI organs removal increases risk for what

Answer 1

nutritional deficiencies

Question 2

diagnosis often given to people with abd pain, fullness, distension, constipation

Answer 2

irritable bowel syndrome

Question 3

causes of serious GI disease

Answer 3

inflammatory
infectious
autoimmune
neoplastic

Question 4

how to discern a serious GI disease

Answer 4

intensity and chronicity of symptoms, vomiting, physical exam findings, specific blood test results

Question 5

where vomiting signals can come from

Answer 5

signal initiated in pharynx, esophagus, stomach and upper SI but any part of GI tract can be irritated

Question 6

afferent and efferent impulses of vomiting

Answer 6

• signal to brainstem via SS and vagus

- efferent from vomiting centre in brainstem (cranial nerves, vagus, SS, spinal motor neurons, abd muscles)

Question 7

prevomiting prep

Answer 7

reverse peristaltis (as far down as ileus)

Question 8

what triggers vomiting

Answer 8

propulsion of intestinal chyme into the stomach

Question 9

2 causes of vomiting

Answer 9

1. GI tract problem

2. chemoreceptor trigger zone stimulus (in brainstem vomiting centre), acute trauma,, odours, toxins and drugs, ..

Question 10

nausea def

Answer 10

awareness that body is preparing to vomit (but won’t necessarily vomit)

Question 11

consequences of nausea

Answer 11

inhibits hunger and appetite

induces anorexia

Question 12

anorexia def

Answer 12

loss of appetite and hunger, unwilligness to eat

Question 13

causes of anorexia

Answer 13

1. survival appropriate (GI tract obstruction, GI tract pain)
2. systemic inflammation (GI tract especially)
3. emotional distress (ex. depression)
4. side effect of certain drugs

Question 14

systemic inflammation def

Answer 14

(also called acute-pjhase response). phgy response to serious tissue injury or microbial invasion

Question 15

2 kinds of inflammatory mediators

Answer 15

• released by specific cells (neutrophils, platelets, mast cells = PGs, cytokines, histamine)
• synthesized in the liver (kininogens that become kinins)

Question 16

cytokines def and best known ones

Answer 16

inflamm mediators from lymphocytes or macrophages. (TNF, IL-1, IL-6 ,..)

Question 17

chemokine def

Answer 17

cytokines that recruite leukocytes (WBCs) to sites of inflammation

Question 18

3 ways acute inflammation solves

Answer 18

1. resolves completely
2. heals with scars (collagen and fibrosis)
3. low-grade chronic inflam persists

Question 19

consequences of systemic inflamm

Answer 19

• HP adrenal axis activ
• muscle protein catabolism
• higher REE
• anorexia
• fatigue, disuse muscle atrophy

Question 20

cause of muscle atrophy in systemic inflammation

Answer 20

muscle protein catabolism

Question 21

acute phase proteins def and main regulator

Answer 21

liver-synthesized proteins with a conc that increases or decreases as part of acute-phase response
mainly mediated by IL-6

Question 22

inflammation increases conc of what proteins + name for these

Answer 22

POSITIVE acute phase proteins: C-reactive protein, haptoglobin, fibrinogen, ferritin, cerruloplasmin

Question 23

inflammation decreases conc of what proteins + name for these

Answer 23

NEGATIVE acute-phase proteins: albumin, transferrin

Question 24

transferrin vs ferritin

Answer 24

• transferrin takes Fe from GI to liver (lower in inflammation)
• ferritin stores Fe (higher in inflammation)

Question 25

why inflamm changes body compartments

Answer 25

1. exudation and capillary permeability

2. some albumin goes to IS

Question 26

lab test showing systemic inflamm and expanded IS compartment and why this happens

Answer 26

low blood albumin. bc systemic cap permeability and albumin leaks in IS space

Question 27

symtoms that almost always acommpagnies systemic inflammation

Answer 27

anorexia and fatigue

Question 28

fatigue def

Answer 28

feeling of low energy, dinsclination to move

Question 29

cachexia def (or cachexia-anorexia syndrome)

Answer 29

generalized muscle atrophy caused by a chronic low-grade systemic inflammation

Question 30

cachexia common in what diseases

Answer 30

• inflammation associated with organ failure (lungs, hearts, kidneys, liver)
• some cancers
• some auto-immune diseases

Question 31

2 things that work together to cause cachexia

Answer 31

• anorexia induced by systemic inflammation

- increased muscle catabolism

Question 32

fatigue (symptom) occurs in what 4 situations

Answer 32

• normal fatigue
• caused by systemic inflammation
• functional chronic fatigue
• chronic fatigue syndrome

Question 33

normal fatigue def

Answer 33

normal given a certain situation

Question 34

fatigue caused by systemic inflamm def

Answer 34

chronic inflamm causes it + worsened by anorexia, muscle wasting and less activity

Question 35

functional chronic fatigue def

Answer 35

fatigue lacking medical explanation and that has been going for at least 6 months typically

Question 36

symptoms associated with functional chronic fatigue

Answer 36

IBS, allodynia (increased aversion to pain), disordered sleep, chronic partial muscle contraction and pain hypersensitivity

Question 37

functional chronic fatigue: food intake of patients

Answer 37

may be normal increased or decreased.

not necessarily decreased as in fatigue caused by systemic inflamm

Question 38

chronic fatigue syndrome def

Answer 38

subvariant of functional chronic fatigue with specific symptoms

Question 39

chronic fatigue syndrome symptoms

Answer 39

loss of memory, inability to concentrate, sore throat, enlarged neck lymph nodes, muscle and joint pain

Question 40

2 examples of diseases causing chronic fatigue syndrome and why

Answer 40

-infectious mononucleosis
-viral hepatitis
(bc fatigue extends beyond infection)

Question 41

what is the cause of chronic fatigue syndrome

Answer 41

a state of subtle persistent immunological or neurohormonal activation