obesity

Question 1

fuel storage
liver + muscles: glycogen
adipocytes: fat

Answer 1

obesity

Question 2

fuel storage
liver + muscles: glycogen
adipocytes: fat

Answer 2

obesity

Question 3

BMI

Answer 3

weight (kg)/

(height (m))^2

Question 4

underweight BMI

Question 5

normal BMI

Answer 5

18.5-24.9

Question 6

overweight BMI

Answer 6

25.0-29.9

Question 7

obese BMI

Answer 7

equal or > 30

Question 8

hypothalamic nuclei involved in regulation of hunger

Answer 8

paraventricular nuclei
dorsal medial nuclei
arcuate nucleus
involve LEPTIN:
lateral hypothalamus (“lateral likes lunch - but lesion/leptin lateral you get little”: stimulation → hunger, INHIBITED by LEPTIN from adipocytes→ anorexia
ventromedial nuclei: STIMULATED by LEPTIN → satiety, lesion → hyperphagia

Question 9

hypothalamic nuclei involved in regulation of hunger

Answer 9

paraventricular nuclei
dorsal medial nuclei
arcuate nucleus
involve LEPTIN:
lateral hypothalamus (“lateral likes lunch - but lesion/leptin lateral you get little”: stimulation → hunger, INHIBITED by LEPTIN from adipocytes→ anorexia
ventromedial nuclei: STIMULATED by LEPTIN → satiety, lesion → hyperphagia

Question 10

BMI

Answer 10

weight (kg)/

(height (m))^2

Question 11

underweight BMI

Question 12

normal BMI

Answer 12

18.5-24.9

Question 13

overweight BMI

Answer 13

25.0-29.9

Question 14

obese BMI

Answer 14

equal or > 30

Question 15

function of adipocytes

Answer 15

store TG’s from blood (greater capacity than liver cells)
synthesize FA/TG from carbs
break down stored fats → release FA for energy
produce LEPTIN: when adipocytes are full, tell hypothalamus that they have enough energy stored as fat (stop eating!)

Question 16

hypothalamic nuclei involved in regulation of hunger

Answer 16

paraventricular nuclei
dorsal medial nuclei
arcuate nucleus
involve LEPTIN:
lateral hypothalamus (“lateral likes lunch - but lesion/leptin lateral you get little”: stimulation → hunger, INHIBITED by LEPTIN from adipocytes→ anorexia
ventromedial nuclei: STIMULATED by LEPTIN → satiety, lesion → hyperphagia

Question 17

leptin control of hypothalamic nuclei: ↓ APPETITE

Answer 17

lateral hypothalamus: INHIBITED by LEPTIN

ventromedial nuclei: STIMULATED by LEPTIN

Question 18

2 signals for fat utilization of adipocytes

Answer 18

↑ sympathetic tone in both states→↑ NE, epi released from adrenal medulla → epi activates hormone-sensitive TG lipase in fat cells → breakdown TG, mobilization of FA to be used by muscles as energy

1) heavy exercise
2) stress: also stimulates ↑ACTH →↑ cortisol → cortisol ALSO activates TG lipase in fat cells

Question 19

local atrophy of adipocytes or hyperplasia of adipocytes + abnormal fatty deposits
abdominal obesity with no fat on extremities
associated with cushing syndrome: cortisol triggers mobilization + redistribution of fat = buffalo hump = type of lipodystrophy

Answer 19

lipodystrophy

Question 20

causes of lipodystrophy

Answer 20

leptin deficiency
HIV meds (protease inihbitors)
cushing syndrome: buffalo hump

Question 21

medications that can ↑ weight gain

Answer 21

atypical antipsychotics
mirtazapine (antidepressant)
insulin, TZD, sulfonylurea
some progestins

Question 22

complications of obesity

Answer 22

gout
gall stones: female, fat, fertile, fourty
fatty liver
osteoarthritis (hips, knees)
candidal infection in skin folds
↑cancer: esophageal, colon, liver, gallbladder, pancreatic, breast/ovarian/uterine, prostate, non-hodgkin lymphoma, MM
PCOS

Question 23

cause: obesity, type 2 DM, hyperlipidemia, insulin resistance
insulin resistance at liver → excess lipid accumulation in liver
NAFL → NASH → cirrhosis (↑ risk HCC)
can worsen hep C progression
CHRONICALLY elevated ALT/AST + alk phos

Answer 23

nonalcoholic steatohepatitis (NASH)

fat accumulation in hepatocytes causes with inflammation (neutrophils, collagen) of liver + elevated LFTs

looks like early changes seen in heavy drinker (alcoholic fatty liver→alcoholic hepatitis →cirrhosis)

Question 24

diagnosis of nonalcoholic steatohepatitis (NASH)

Answer 24

liver US, CT scan, MRI MRS: (gold standard)

liver bx