Feb6 M2-Anorexia and Cachexia Flashcards
GI organs removal increases risk for what
nutritional deficiencies
diagnosis often given to people with abd pain, fullness, distension, constipation
irritable bowel syndrome
causes of serious GI disease
inflammatory
infectious
autoimmune
neoplastic
how to discern a serious GI disease
intensity and chronicity of symptoms, vomiting, physical exam findings, specific blood test results
where vomiting signals can come from
signal initiated in pharynx, esophagus, stomach and upper SI but any part of GI tract can be irritated
afferent and efferent impulses of vomiting
- signal to brainstem via SS and vagus
- efferent from vomiting centre in brainstem (cranial nerves, vagus, SS, spinal motor neurons, abd muscles)
prevomiting prep
reverse peristaltis (as far down as ileus)
what triggers vomiting
propulsion of intestinal chyme into the stomach
2 causes of vomiting
- GI tract problem
2. chemoreceptor trigger zone stimulus (in brainstem vomiting centre), acute trauma,, odours, toxins and drugs, ..
nausea def
awareness that body is preparing to vomit (but won’t necessarily vomit)
consequences of nausea
inhibits hunger and appetite
induces anorexia
anorexia def
loss of appetite and hunger, unwilligness to eat
causes of anorexia
- survival appropriate (GI tract obstruction, GI tract pain)
- systemic inflammation (GI tract especially)
- emotional distress (ex. depression)
- side effect of certain drugs
systemic inflammation def
(also called acute-pjhase response). phgy response to serious tissue injury or microbial invasion
2 kinds of inflammatory mediators
- released by specific cells (neutrophils, platelets, mast cells = PGs, cytokines, histamine)
- synthesized in the liver (kininogens that become kinins)
cytokines def and best known ones
inflamm mediators from lymphocytes or macrophages. (TNF, IL-1, IL-6 ,..)
chemokine def
cytokines that recruite leukocytes (WBCs) to sites of inflammation
3 ways acute inflammation solves
- resolves completely
- heals with scars (collagen and fibrosis)
- low-grade chronic inflam persists
consequences of systemic inflamm
- HP adrenal axis activ
- muscle protein catabolism
- higher REE
- anorexia
- fatigue, disuse muscle atrophy
cause of muscle atrophy in systemic inflammation
muscle protein catabolism
acute phase proteins def and main regulator
liver-synthesized proteins with a conc that increases or decreases as part of acute-phase response
mainly mediated by IL-6
inflammation increases conc of what proteins + name for these
POSITIVE acute phase proteins: C-reactive protein, haptoglobin, fibrinogen, ferritin, cerruloplasmin
inflammation decreases conc of what proteins + name for these
NEGATIVE acute-phase proteins: albumin, transferrin
transferrin vs ferritin
- transferrin takes Fe from GI to liver (lower in inflammation)
- ferritin stores Fe (higher in inflammation)
why inflamm changes body compartments
- exudation and capillary permeability
2. some albumin goes to IS
lab test showing systemic inflamm and expanded IS compartment and why this happens
low blood albumin. bc systemic cap permeability and albumin leaks in IS space
symtoms that almost always acommpagnies systemic inflammation
anorexia and fatigue
fatigue def
feeling of low energy, dinsclination to move
cachexia def (or cachexia-anorexia syndrome)
generalized muscle atrophy caused by a chronic low-grade systemic inflammation
cachexia common in what diseases
- inflammation associated with organ failure (lungs, hearts, kidneys, liver)
- some cancers
- some auto-immune diseases
2 things that work together to cause cachexia
- anorexia induced by systemic inflammation
- increased muscle catabolism
fatigue (symptom) occurs in what 4 situations
- normal fatigue
- caused by systemic inflammation
- functional chronic fatigue
- chronic fatigue syndrome
normal fatigue def
normal given a certain situation
fatigue caused by systemic inflamm def
chronic inflamm causes it + worsened by anorexia, muscle wasting and less activity
functional chronic fatigue def
fatigue lacking medical explanation and that has been going for at least 6 months typically
symptoms associated with functional chronic fatigue
IBS, allodynia (increased aversion to pain), disordered sleep, chronic partial muscle contraction and pain hypersensitivity
functional chronic fatigue: food intake of patients
may be normal increased or decreased.
not necessarily decreased as in fatigue caused by systemic inflamm
chronic fatigue syndrome def
subvariant of functional chronic fatigue with specific symptoms
chronic fatigue syndrome symptoms
loss of memory, inability to concentrate, sore throat, enlarged neck lymph nodes, muscle and joint pain
2 examples of diseases causing chronic fatigue syndrome and why
-infectious mononucleosis
-viral hepatitis
(bc fatigue extends beyond infection)
what is the cause of chronic fatigue syndrome
a state of subtle persistent immunological or neurohormonal activation