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Clin Med Diabetus/Obesity > Obeesiteh & PCOS > Flashcards

Obeesiteh & PCOS Flashcards

1
Q

What is Kwashiorkor caused by?

A

protein deficiency (but adequate energy)

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2
Q

When is Kwashiorkor often seen?

A

often seen in weaning infants at birth of a sibling in areas where protein foods aren’t abundant
-can occur even in overweight

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3
Q

onset and protein levels of Kwashiorkor

A

may be abrupt onset and low albumin (edema, etc)

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4
Q

Marasmus caused by

A

deficiency of both protein and energy

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5
Q

Where is marasmus seen

A

in areas where not enough food available

-associated with fat and muscle wasting

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6
Q

onset, protein levels of marasmus

A

slower onset and albumin level may be normal

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7
Q

Kwashiorkor-like secondary protein-energy malnutrition

-associated with what?

A

hypermetabolic acute illness like trauma, burns, sepsis

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8
Q

Marasmus-like secondary protein-energy malnutrition

associated with what?

A

COPD, CHF, AIDS, cancer

-number of calories they’re taking in aren’t enough to keep up w/ energy expended from/by diseases

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9
Q

list of things that cause protein-energy malnutrition

A
  • not enough energy or protein ingested
  • increased nutrient losses
  • increased nutrient requirements by underlying illness
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10
Q

Refeeding in protein-energy malnutrition

A
  • ***must be slow and careful b/c mineral/electrolyte problems during referring
  • will need vitamin and mineral supplements
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11
Q

Main vitamin that should be supplemented?

A

Vitamin D

  • essential for bone mineralization
  • deficiency associated with increased risk for colorectal, breast, and prostate cancers
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12
Q

Thiamine deficiency usually associated with

A

alcohol

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13
Q

riboflavin deficiency usually because

A

of multiple vitamin deficiencies

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14
Q

niacin deficiency

A

usually alcohol related

  • niacin helpful for treating lipids
  • severe deficiency causes dermatitis, diarrhea
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15
Q

vitamin C deficiency

A

urban poor, elderly, renal failure

-scurvy, bleeding gums, edema

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16
Q

What two vitamins necessary for RBC division

and what if deficient

A

B12 and folate

macrocytosis if deficient

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17
Q

B vitamin deficiencies

A

mouth soreness, glossitis, weakness, irritability

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18
Q

B12 deficiency

A
  • Macrocytic anemia, neuropathy
  • B12 stores last a long time
  • Intrinsic factor protects is (schilling test to see if IF is reason for B12 deficiency)
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19
Q

Folate deficiency

A
  • usually dietary deficiency
  • **folate stores are short-lived so highly dependent on diet
  • macrocytic anemia without neurologic defects
20
Q

If B12 deficiency and supply folate, what happens?

A

macrocytic anemia will correct but neurological will become permanent

21
Q

Vit A deficiency and excess

A
  • Deficiency can cause blindness

- hypervitaminosis very toxic

22
Q

Vit D

-essential for what?

A

bone mineralization

23
Q

Vit E deficiency

A

usually due to malabsorption

24
Q

Vit E supplementation

A

causes more harm than good for CVD

25
Q

D-xylose test

A
  • tests for bacterial overgrowth in gut
  • we can’t digest xylose but bacteria can
  • look for labeled Co2 when xylose broken down
26
Q

underweight BMI range

A

less than 18.5

27
Q

normal BMI range

A

18.5-24

28
Q

overweight BMI range

A

25-29

29
Q

Obese BMI range

A

> 29

30+

30
Q

Obesity causes increased risk for

A
  • insulin resistance/diabetes
  • metabolic syndrome
  • CVD, stroke, MI
  • cancer
  • MS problems/arthritis
31
Q

What does adiponectin do?

What happens when obese?

A

repairs vascular walls and regulates inflammation

-adiponectin decreases with obesity

32
Q

Obesity is worse/ higher CVD risk if what?

A

higher level of inflammation within fat

33
Q

Drugs indicated for chronic obesity treatment

A

Xenical/orlistat

34
Q

short term weight loss drugs

A

amphetamines suppress appetite, other drugs with unintentional weight loss side effect

35
Q

Types of Bariatric surgeries

A
  1. Restrictive reduces stomach size for earlier satiety
  2. Malabsorptive more effective, prevents nutrients from being absorbed
  3. Combination also very effective- gastric bypass with some malabsorption
36
Q

PCOS general definition

A
  1. ovulatory dysfxn
  2. hyperandrogenism (must exclude other causes like ovarian tumor, etc)
  3. exclusion of other disorders
  4. possible polycystic ovaries
37
Q

Things usually present with PCOS

A
  • usually overweight/obese
  • insulin resistance or hyperinsulinemia
  • elevated LH levels
  • hyperandrogenism from hyperinsulinemia
  • anovulation
  • strong family clustering
  • prevalence of metabolic syndrome higher than general population
38
Q

PCOS Lab Findings

A
  • elevated LH but normal FSH
  • increased testosterone
  • ***insulin resistance with compensatory hyperinsulinemia (key pathogenic factor in PCOS)
39
Q

Clinical Features of PCOS

A
  • acanthosis nigricans
  • acne
  • alopecia
  • amenorrhea or dysfxnl menses
  • central obesity
  • hirsutism
40
Q

PCOS pts have increased risk of what CVD disease?

A

7-fold increased risk of MI

41
Q

Best first-line treatment for PCOS

A
  • lifestyle modification with diet & exercise

* *weight loss, low fat and low carb diet

42
Q

What medicine to treat infertility in PCOS?

A

Clomiphene

43
Q

How to treat complaints of PCOS?

A
  • oligomenorrhea: estrogen-progestin therapy
  • hirsutism- estrogen progestin
  • anovulation/infertility: clomiphene
44
Q

drug treatments for weight loss

A
  • Orlistat fat blocker
  • amphetamines for short term appetite suppression
  • bariatric surgery
45
Q

insulin sensitizing agents

A
  • metformin (biguanide) and

- thiazolidinediones

Clin Med Diabetus/Obesity (2 decks)

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