Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

M104 Symposia > M104 Symposia Obesity part 2 > Flashcards

M104 Symposia Obesity part 2 Flashcards

1
Q

What are examples of anorexigenic gut hormones?

A 
Cholecystokinin (CCK)
Pancreatic Polypeptide (PP)
Peptide YY (PYY)
Glucagon-like Peptide (GLP)-1
Oxyntomodulin (OXM)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is an example of a orexigenic hormone?

A

Ghrelin - hunger
the only one we know of
is still under investigation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Leptin

A

Rather than a signaler for satiety in deficiency signals starvation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What hormone increases as weight does?

A

Leptin

rather than a signaler for satiety, it’s more of a signaller for starvation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What happens when food is eaten and it reaches the stomach?

A

chemicals signallers are sent to the hypothalamus via the vagal nerve to inform the brain that the person has eaten and that it’s time to stop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the effect of leptin?

A

We seem to be quite resistant or not recognising the increase in leptin
there is some evidence that we’ve become desensitised to leptin as we put on weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What happens if leptin levels drop from what they are usually?

A

it substantially increases hunger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What happens in people with a leptin deficiency or those who have no leptin at all?

A

they would be in a state of starvation all the time

very overweight people seeking out food 24/7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is a leptin deficiency treated?

A

leptin injection, injectable therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the effect of GLP-1 therapy?

A

reduces appetite

still under investigation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is GLP-1 therapy used in conjunction with?

A

type 2 diabetes treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are examples of internal drivers of hunger?

A

Stress hormones: adrenaline/ cortisol
Circadian rhythm – sleep deprivation
Genetics
Microbiome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What mutation was found in up to 5% of kids?

A

the MC4R mutation

strong link to hyperphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is appetite associated with?

A

it’s genetically determined with a growing number of genetic mutations associated with small increases in appetite and higher prevalence of obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the effect of the FTO gene variant?

A

it seems to increase your risk of obesity

it confirms a very high heritability of weight, that’s equal actually to height

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the role of microbiome in the SI?

A

to help digest food, especially high fibre foods that are passed on to lower intestine
to produce vitamin K and metabolic metabolites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does SI microbiome vary in people with T2 diabetes?

A

people with T2 DM tend to have less variety and reduced quantity of microbes in their gut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What has happened to obese mice who received faecal transplant from slim mice compared to the same experiment in humans?

A

the obese mice lost weight

the experiments in humans so far has been a bit mixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the three main components to total E expenditure?

A

AEE
DIT
BMR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a benefit of 5 - 10% weight loss?

A

50% reduction in chance of getting diabetes

reduces symptoms of obesity

21
Q

What is the effect of a sustained 15kg weight loss for people with newly diagnosed type 2 diabetes?

A

it is likely to provide the greatest chance of remission

22
Q

What are the different tiers of obesity treatment in the UK?

A

Tier 1 - giving public health advice and using population-wide opportunities for interventions, e.g. the advertising of junk food
T2 - interventions via group support or health trainers
T3 - dieticians specialising in obesity working with a team of psychologists who assess for medication interventions
T4 - surgery and bariatric surgery (rare)

23
Q

What is a side effect of orlistat?

A

can cause steatorrhoea

24
Q

What are the beneficial effects of orlistat?

A

30% less fat absorbed

this is equal to 200kcal on avg

25
Q

What might patients on orlistat need?

A

Vitamin D supplements

26
Q

In what conditions should orlistat treatment be continued?

A

if >=5% weight loss is achieved within 12 weeks

27
Q

What’s the evidence for orlistat?

A

there is no long term data on clinical outcomes

28
Q

What groups is orlistat appropriate for?

A

adults only

should be avoided in > 75 years

29
Q

What receptor does liraglutide bind to and activate?

A

the GLP-1 receptor

30
Q

What groups is liraglutide used for?

A

individuals with a body mass index (BMI) of 30 kg/m2 or more

individuals with a BMI of 27 kg/m2 or more in the presence of at least one weight-related co-morbidity

31
Q

What is the effect of liraglutide?

A

increases insulin secretion
suppresses glucagon secretion
slows gastric emptying

32
Q

How is liraglutide administered?

A

a weekly subcutaneous injection

33
Q

When is liraglutide discontinued?

A

if at least 5% of initial body-weight has not been lost after 12 weeks at maximum dose

34
Q

When is bariatric surgery used?

A

when other interventions fail

35
Q

What is the eligibility for bariatric surgery?

A

BMI >= 40 (prior to 2018 it was 35)
BMI 35-40 with co-morbidity (prior to 2018 was 30-35)
Obese Asian patients with Type II DM

36
Q

What is the outcome of bariatric surgery?

A

65% reversal of Type II DM

37
Q

What percentage of the NHS budget is currently used to treat DM?

A

10%

38
Q

What are the expenses and total cost for the 2 year follow up after a bariatric surgery?

A

dietician, psychology, nurse, exercise therapist

around £12,000

39
Q

What are the three different types of bariatric surgery?

A

Laparoscopic adjustable band
Sleeve gastrectomy
laparoscopic gastric bypass

40
Q

What are the effects of gastric sleeve surgery?

A

since your stomach will be considerably smaller, the patient will feel full much more quickly
the part of the stomach that produces an appetite-boosting hormone will be removed, which is likely to reduce hunger pangs

41
Q

What are two negatives of gastric band surgery?

A

band may erode stomach/slip

slow weight loss

42
Q

What is laparoscopic gastric bypass otherwise known as?

A

Roux-en-Y

43
Q

What are the nutritional requirements required post-surgery after gastric banding and sleeve gastrectomony?

A

multivitamins and minerals

44
Q

What multivitamins and minerals are required after a sleeve gastrectomony?

A

Fe, Ca, Vit D, B12 injection

45
Q

What levels are monitored after gastric banding?

A

U&E, FBC, LFTs, HbA1c, lipids

46
Q

What levels are monitored after a sleeve gastrectomony?

A

U&E, FBC, LFT, Ferritin, folic acid, Ca, Vit D, B12, Zn and Cu, parathyroid hormone, lipids

47
Q

What are the effects of a sleeve gastrectomony that can be found using a DXA scanner?

A

there is no clear consensus but it can lead to a Ca deficiency, 2ry hyperparathyroidism, increased Vit D activation and Ca resorption from bone that could lead to bone loss

48
Q

What can be done to address the potential effects of sleeve gastrectomony on bone?

A

Consider annual DXA until stable

AVOID bisphosphonates

M104 Symposia (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions