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BMS3052 > Obesity > Flashcards

Obesity Flashcards

1
Q

Do you need to know what the BMI classifications are

A

Yes

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2
Q

Do you need to know what risk factors for obesity are?

A

Yes

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3
Q

Do you need to now the prevalence of obesity - both globally and locally?

A

Yes

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4
Q

Is there a genetic predisposition to obesity?

Does obesity tend to be monogenic or polygenic?

A

Polygenic

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5
Q

4 genetic causes of obesity

A

Prader Willi syndrome
Leptin deficiency
Leptin receptor deficiency
FTO gene

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6
Q

Prader Willi:

  • Do you need to know what gene is mutated, and by what mechanisms?
  • Do you need to know the symptoms of Prader Willi syndrome?
  • Do you need to know the various ways that Prader Willi predisposes to obesity?
  • One hormonal factor that predisposes those with Prader Willi to obesity?
A

YEs
YEs
Yes
Increased ghrelin levels

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7
Q

Leptin deficiency

  • Describe how it contributes to obesity
  • Can it be cured with leptin replacement?
  • Do you need to know rat studies?
A

Mutation in ob gene –> leptin not produced. Lack of satiety signal –> constantly hungry and eating –> obesity
Yes
Yes

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8
Q

Leptin receptor mutations

  • Can it be cured with leptin replacement?
    • Do you need to know rat studeis?
A

No

Yes

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9
Q

Sometimes, are environmental factors needed to unmask genetic predisposition to obesity?

A

Yes

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10
Q

Can set point be re established in children and adults? Implication?
Do you need to know study?

A

Only children - can reestablish weight trajectory.

Yes

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11
Q

Do you need to know animal studies?

A

Yes

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12
Q

What would you expect to happen when you increase energy expenditure vs what actually happens, and why?

A

Lose weight

Weight maintained - as compensatory increase in food intake

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13
Q

Do you need to know how GWAS discovered FTO as an obesity susceptibility gene?
Do you need to know specific actions of FTO?
Do you need to know studies?

A

Yes
Yes
Yes

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14
Q

Do you need to know

  • Various brain nuclei involved in appetite
  • Dual centre hypothesis - VMH and LH
  • Is everything else in the visual diagram?
A

Yes
Yes
Yes

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15
Q

Do you need to know the following aspects about metabolic syndrome:
-Definition/diagnosis
Risk factors
Consequences

A

Yes

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16
Q

Is BMI assocaited with increased chronic illness risk and mortality

A

Yes

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17
Q

Do you need to know the following about T2D:

  • Prevalence
  • Heritability
  • Diagnosis
A

Yes

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18
Q

Do you need to know about insulin resistance mechanisms in the liver, skeletal muscle and adipose tissue?

A

Yes

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19
Q

Where does glucose uptake primarily occur, and what is the primary site of insulin resistance?

A

Skeletal muscle

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20
Q

Describe the two phases of type 2 diabetes pathogensis

A

Insulin resistance occurs.

Initially, beta cells secrete more insulin to keep BGLs stable. But then beta cells undergo failure –> BGLs soar

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21
Q

What 4 mechanisms contribute to insulin resistance?

Do you need to know these in detail?

A

Lipotoxicity
Inflammation
Altered endocrine signals
Mitochondrial dysfunction

Yes

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22
Q

Do you need to know the classifications of physical activity intensity, in terms of metabolic equivalents of tasks?

A

Yes

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23
Q

What is an active couch potato

A

People who are highly active byt highly sedentary

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24
Q

What fraction of people worldwide are physically inactive? Are males or females more inactive?

A

1/4, generally females.

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25
Q

Do you need to konw types of self reported and device based methods for measuring sedentary behaviour?
Do self reported measures tend to under report?

A

Yes

Yes

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26
Q

Do you need to know the health consequences of sedentary behaviour?

A

Yes

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27
Q

What combination of activity vs sedentary behaviour results in highest risk of mortality?

A

Low activity, high sedentary

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28
Q

Has COVID increased sedentary time and decreased physical activity time?

A

Yes

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29
Q

What are the 4 mechanisms through which sedentary behaviour increases chronic illness risk? Do you need to know these?

A

Increased blood glucose
Increased blood pressure
Impaired vascular function
REduced cerebral blood flow

Yes

30
Q

Do you need to know the 3 studies?

A

Yes

31
Q

Do you need to know the guidelines

A

Yes

32
Q

what are the 3 components of energy expenditure?

A

Obligatory energy expenditure
Physical activity
Adaptive thermogenesis

33
Q

Obligatory energy expenditure is aka

A

resting energy expenditure

basal metabolic rate

34
Q

Is BMR correlated to lean (fat free) body mass?
Do females have lower BMR than males?
Does BMR decrease over the lifespan

A

Yes Yes Yes

35
Q

Is weight change in response to exercise genetically determined? Do you need to know the studies?

A

Yes

36
Q

Do you need to know the exercise requirements for clinically significant weight loss?

A

Yes

37
Q

Do you need to know the benefits of exercise beyond weight loss?

A

Yes

38
Q

What is non exercise adaptive thermogenesis?

A

Energy used during physical activities that don’t involve volitional exercise

39
Q

What are the 2 sites of adaptive thermogenesis?

A

Brown adipose tissue

Skeletal muscle

40
Q

Brown adipose tussue: describe stimulus and response of adaptive thermogenesis

A

Stimulus: cold, food, energy stores
Increases sympathetic output and NA release
NA binds to B3 receptors on BAT
Activates signalling cascade that releases FFA from lipid droplets; FFA causes conformational change in UCP1 - opens pore, releases heat.

41
Q

BAT: do you need to know studies?

A

Yes

42
Q

In skeletal muscle, describe the types of UCP proteins

A

Mainly UCP3, some UCP2

43
Q

Is UCP3 as effective as UCP2, and if not what counteracts this?

A

No, high skeletal muscle mass

44
Q

In addition to UCPs, what is the other pathway that contributes to thermogenesis in muscle? Do you need to know mechanism?

A

Calcium cycling, yes

45
Q

Do you need to know the interindividual variation in posture allocation - role in human obesity study?

A

Yes

46
Q

Do you need to mnow the location of the adipocyte types, and changes in location over the lifespan

A

Yes

47
Q

Do you need to know

  • Morphological differences between white and brown adipsoe
  • Developmental origin differences of white vs brown adipocytes
  • Browning and whitening of adipose tissues and mechanism
A

Yes Yes Yes

48
Q

After weight loss, what happens to

  • total energy expenditure
  • hunger signals
  • satiety signals
  • Do you need to know the studies?
A

Total energy expenditure decreases
Satiety signals decrease
Hunger signals increase

49
Q

Do you need to understand weight cycling? What happens to weight over time?

A

Yes, keeps increasing

50
Q

Do you need to know the mouse yoyo dieting study?

A

Yes

51
Q

Ketogenic diets were initially used to treat

A

children with epilepsy

52
Q

Do you need to know the mechanism of ketogenic diet

A

Yes

53
Q

Do you need to know about sugar tax

A

Yes bih

54
Q

Diabetes complications

  • Chronic hyperglycemia is a major initiator of ________ complications
  • Postprandial hyperglycemia is a powerful predictor of ______ complications aka ___
A

Microvascular

Macrovascular, CVD

55
Q

Do you need to know what the microvascular and macrovascular complications of diabetes are?

A

Yes

56
Q

Diabetes treatments: do you need to know

  • Types of therapies
  • Costs
  • Timeline
A

Yes Yes Yes

57
Q

What is the main T2DM treatment

A

Metformin

58
Q

Does metformin have a good safety profile

A

Yes

59
Q

Describe metformin mechanism of action

A

-Activates AMPK in skeletal muscle –> increased GLUT4 translocation
Activates AMPK in liver –> decreased GNG
Impairs absorption of glucose from the gut

60
Q

Does metformin affect insulin secretion?

A

No - rather, impacts peripheral tissues to increase insulin sensitivity

61
Q

Do you need to know about the 10 year follow up of intensive glucose control in T2D?

A

Yes

62
Q

Do you need to know about old obesity drugs and their disadvantages?

A

Yes

63
Q

For obesity, what are the 4 new drug development strategies

A

Personalised medicine
Targeted therapy
Monotherapies
Combination therapies

64
Q

Orlistat

  • What is mechanism
  • Side effects
A

A lipase inhibitor - fat droplets pass through

Cramping, gas, diarrhea, anal leakage, oily underwear stains

65
Q

Contrave is made of what 2 drugs

Do you need to know mechanism of action, rat and human studies?

A

Buproprion and Naltrexone

Yes

66
Q

Do you need to know about liraglutide - mechansim of action, studies?

A

Yes

67
Q

What is the only effective mechanism of long term weight loss?

A

Bariatric surgery.

68
Q

What are the 3 types?

A

Gastric banding
Sleeve gastrectomy
Roux en Y gastric bypass

69
Q

Which is most effective and most invasive?

Which is mainly used in Aus, which in USA?

A

Roux on Y, Roux en Y
Sleeve gastrectomy
Roux en Y

70
Q

Gastric sleeve:
-Mechanisms of action?
Does it have immediate effects to improve glycemic control?

A

Stomach holds less –> increased satiation

Less ghrelin

BMS3052 (15 decks)

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