Obesity Flashcards
What are the two gut homes that are involved in weight control?
Gherlin
Glucagon-like peptide (GLP-1)
Where is Gherlin found? What does it do?
Fundus of the stomach
ONLY KNOWN CIRCULATING OREXIGEN or APPETITE STIMULANT
Also increases secretion of growth hormone, cortisol and epinephrine
When do you see gherkin suppression with gastric bypass surgery?
because it involves removal of the funds of the stomach, where it is made
What does Glucagon-like Peptide 1 do?
Enhances insulin release
Improves beta cell function
Inhibits glucagon secretion
delays gastric emptying
Decreases food intake
Where is GLP 1 found?
distal ileum and colon
How does GLP1 improve DM?
through effects on Glucagon, insulin, food intake and weight loss from anorexic effects of bariatric surgery
What are some CV effects of obesity?
Increase in circulating blood volume, plasma volume and CO
Increase blood volume –> increased preload & after load
All can lead to BiVent failure
HTN
___ L/Min increase in CO for every ____ of body fat
0.1 ; 1kg
What are some respiratory effects of obesity?
Increased demand and decreased supplyH
How does Obesity increase O2 demand?
increased oxygen consumption and CO2 production
Leads to increased alveolar ventilation
How does obesity decrease supply?
Decreased Chest wall compliance –> decreasing lung volume
Decreased FRC and EVR
Premature airway closure due to an increase in closing volume and capacity
What is closing volume
volume of gas in the lungs in excess of the RV at a time when the small airways close during maximum exhalation
What odes increased closing volume lead to?
Atelectasis and shunting of blood
Why is WOB increased in obese pts?
elevation of the diaphragm from fat layers on chest wall and abdomen
What three factors predict a return to DM after bariatric surgery?
long duration of DM
poor blood sugar control preop
required insulin therapy