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brs (phase 1b) > (gastro) disorders of appetite > Flashcards

(gastro) disorders of appetite Flashcards

1
Q

define polydipsia

A

excessive thirst or excess drinking

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2
Q

define adipsia

A

inappropriate lack of thirst |(even in severe dehydration)

= with consequent failure to drink in order to correct hyperosmolality

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3
Q

define anorexia

A

lack or loss of appetite for food

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4
Q

define obesity

A

abnormal or excessive fat accumulation that presents a risk to health

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5
Q

what types of polydipsic disorders are there?

A

primary polydipsia = psychogenic and dipsogenic polydipsia

secondary polydipsia

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6
Q

what types of adipsic disorders are there?

A

four types (A-D)

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7
Q

what are the types of primary polydipsia?

A

psychogenic = seen in patients with psychiatric disorders

dipsogenic = seen in patients w hypothalamic conditions

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8
Q

differentiate between primary and secondary polydipsia?

A

primary = a condition where there is excess consumption of fluids leading to polyuria with diluted urine and, ultimately, hyponatremia

secondary = drinking excess water due to disease-induced or medication-induced thirst prompted by an actual need for water

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9
Q

which is the more common type of polydipsia?

A

secondary polydipsia = more common

(diseases can disrupt the steps of osmoregulation or alter ADH secretion)

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10
Q

what are the causes of secondary polydipsia?

A

pic

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11
Q

which chronic medical conditions can cause secondary polydipsia?

A

diabetes insipidus & mellitus

kidney failure

Conn’s syndrome

Addison’s disease

sickle cell anaemia

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12
Q

which medications can cause secondary polydipsia?

A

diuretics

laxatives

antidepressants

(top two result in dehydration)

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13
Q

which forms of dehydration lead to secondary polydipsia?

A

acute illness
sweating
fevers
vomiting
diarrhoea
underhydration

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14
Q

what are the most common causes of secondary polydipsia?

A

diabetes and kidney failure

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15
Q

differentiate between diabetes insipidus and diabetes mellitus

A

diabete insipidus

  • relatively uncommon
  • related to pituitary problems
  • impaired ADH production

diabetes mellitus

  • very common
  • related to high blood sugar
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16
Q

compare the treatment for diabetes mellitus to diabetes insipidus

A

diabetes mellitus = treat the high blood sugar

diabetes insipidus = treat with desmopressin

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17
Q

what causes the large volume of urine in diabetes mellitus?

A

high sugar levels
= filtered in the kidney and the hypertonic tubular fluid draws more water into the renal filtrate
= forms a higher volume of sugary urine (diuresis)

(higher blood sugar causes diuresis)

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18
Q

why does diabetes mellitus cause polydipsia?

A

high blood sugar induces diuresis

= higher urine output, more dehydrated and thirstier so you drink more

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19
Q

why does diabetes insipidus cause polydipsia?

A

pituitary problems (cranial diabetes insipidus, not nephrogenic)

= lack of ADH
= kidney cannot concentrate the urine
= larger amounts of dilute urine are produced

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20
Q

what are the common symptoms of diabetes?

A
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21
Q

what is Conn’s syndrome alternatively known as?

A

primary aldosteronism

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22
Q

what is Addison’s disease alternatively known as?

A

hypoadrenocorticism

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23
Q

how does Conn’s syndrome lead to polydipisia?

A

dunno whoops

24
Q

how does Addison’s disease lead to polydipsia?

A

adrenocortical insufficiency

= less aldosterone produced
= less H2O retention due to less Na+ and Cl- reabsorption
= larger volumes of more dilute urine produced
= increased water loss from the body
= dehydration
= triggers polydipsia

25
Q

what are the causes of primary polydipsia?

A

mental illness (psychogenic polydipsia)

  • schizophrenia
  • mood disorders
  • anorexia
  • drug use

brain injuries (i.e. to the hypothalamus/pituitary)

organic brain damage

26
Q

what can polydipsia lead to?

A

kidney and bone damage

headache
nausea
cramps

low energy, headache
confusion
seizures, slow reflexes
slurred speech

27
Q

how can polydipsia lead to an electrolyte imbalance?

A

increased water intake
= reduced osmolality of blood
= hyponatraemia
= can lead to expansion of the cells due to the surrounding water

28
Q

give examples of mental disorders defined by abnormal eating habits

A

binge eating disorder

anorexia nervosa

bulimia nervosa

PICA

rumination syndrome

avoidant/restrictive food intake disorder

29
Q

what is binge eating disorder?

A

when a person feels compelled to overeat on a regular basis in a short period of time

30
Q

what is anorexia nervosa?

A

severe and strong fear of gaining weight

31
Q

what is bulimia nervosar?

A

eating large amounts of food and then purging to get rid of extra calories (vomiting/eating laxatives)

32
Q

what is PICA?

A

an eating disorder in which a person eats things not usually considered food

33
Q

what is rumination syndrome?

A

repeatedly and unintentionally spit up (regurgitate) undigested or partially digested food from the stomach

34
Q

what is avoidant/restrictive food intake disorder? (ARFID)

A

extremely picky eaters and have little interest in eating food

35
Q

what are the signs of anorexia?

A

low BMI

continuous weight loss

amenorrhea

halitosis

mood swings

dry hair & skin

hair thinning

36
Q

which hormone is responsible for the mechanism of anorexia?

A

serotonin (suspected)

37
Q

how is anorexia classified?

A

mild: BMI > 17
moderate: BMI of 16–16.99
severe: BMI of 15–15.99
extreme: BMI < 15

38
Q

what is the threshold for mild anorexia?

A

BMI > 17

39
Q

what is the threshold for moderate anorexia?

A

BMI of 16–16.99

40
Q

what is the threshold for severe anorexia?

A

BMI of 15–15.99

41
Q

what is the threshold for extreme anorexia?

A

BMI < 15

42
Q

why is obesity increasing?

A

(not because physical activity levels are declining)

cheap, calorie-rich/nutrient-poor beverages, sweets and fast food are being increasingly eaten

43
Q

what is the first step in obesity management?

A

screen all individuals for being overweight and obesity

44
Q

what does an obesity/weight management history involve?

A

assesses for multiple determinants of obesity

  • dietary and physical activity patterns
  • psychosocial factors
  • weight-gaining medications
  • familial traits
45
Q

what is central/abdominal obesity linked to?

A

increased risk of cardiovascular disease, Alzheimer’s disease, diabetes and asthma

46
Q

what is BMI?

A

body mass index

= calculated as weight in kgs/height in square metres

47
Q

what is BMI measured in?

A

kg/m^2

48
Q

what is the BMI threshold that qualifies for treatment?

A

either BMI of ≥30

or ≥25 + comorbidity or risk factor

49
Q

which of the following is the most effective treatment of obesity?

a) diet
b) exercise
c) diet + exercise
d) none of the above

A

pic

50
Q

when is obesity treated surgically?

A

in patients EITHER
- with a > BMI 40
OR
- 35+ comorbidities

51
Q

what are the most common surgical treatments for obesity?

A

Roux-en-Y gastric bypass

sleeve gastrectomy

52
Q

what is the function of GLP1 and GLP2?

A

stimulate insulin release

inhibit glucagon release

53
Q

what is the function of ghrelin?

A

‘hunger hormone’
NPY activation - stimulate appetite

54
Q

what is the function of PYY?

A

satiety

(anorexigenic = inhibit appetite)

55
Q

what happens to ghrelin levels after bariatric surgery and why?

A

ghrelin levels reduce following bariatric surgery

= as ghrelin is mainly produced by the cells of the gastric fundus, which is removed by sleeve gastrectomy (so less ghrelin release)

56
Q

what happens to GLP1 and GLP2 levels after bariatric surgery and why?

A

both GLP1 and GLP2 levels increase

= nutrients are absorbed lower down the gut after surgery, and this stimulates more of the GLP1-secreting cells, which are found in higher numbers in the lower gut

57
Q

what happens to PYY levels after bariatric surgery and why?

A

PYY levels also increase

(have an appetite inhibiting, and food intake reducing effect)

brs (phase 1b) (71 decks)

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