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MET 2 > Obesity > Flashcards

Obesity Flashcards

1
Q

Define obesity

A

Abnormal or excessive fat accumulation sufficient to adversely affect health and reduce life expectancy

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2
Q

How many girls and boys are obese in 2016

A

Girls= 50 million

Boys=74 millions

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3
Q

How many children in tower hamlets are obese when they start school

A

1 in 8

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4
Q

How many children in tower hamlets are obese when they leave primary school

A

1 in 4

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5
Q

What % of weight issues are related to medication

A

10-15

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6
Q

Name some drugs that can cause weight issues

A

Mood stabilisers
Diabetes medicines
Corticosteroids
Beta blockers

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7
Q

Define lipohypertrophy

A

Enlargement of fat cells where insulin is injected

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8
Q

What T2D drugs increase insulin levels

A

Insulin
Sulfonylureas
TZD

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9
Q

What T2D drugs stabilise insulin levels

A

Metoformin

DPP IV inhibitors (januvia, onglza, trajenta)

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10
Q

What T2D drugs decrease insulin levels

A

SGLT-2 inhibitor

Acarbose

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11
Q

What is meant by the thrifty gene hypothesis

A

Genes that predispose to obesity would have had a selective advantage in populations that frequently experience starvation
People who have these genes may be obese now

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12
Q

What is syndromic monogenic obesity

A

Characterised by mental retardation, dysmorphic features, organ specific abnormalities in addition to obesity

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13
Q

How many genes have been identified to cause syndromic monogenic obesity

A

12

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14
Q

What pathway is thought to be affected in syndromic monogenic obesity

A

Leptin-melanocortic pathway

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15
Q

What is the role of primary cilium

A

Key role in differentiation of adipocytes

Mediates leptin receptor signalling

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16
Q

How many genetic variants have been identified in polygenic obesity

A

227

17
Q

Which niological pathways have been identified as part of the problem of polygenic obesityq

A 
Central nervous system
Food sensing and digestion
Adipocyte differentiation
Insulin signalling
Lipid metabolism
Muscle and liver biology
Gut microbiota
18
Q

2 ways that adipocyte differentiation dysfunction can lead to obesity

A

Ciliopathies

Multations in PPARγ2 (

19
Q

What is PPARγ2

A

Transcription factor that has a key role in adipocyte differentiation

20
Q

What drugs can target mutation in PPARγ2

A

Thiazolidinediones

21
Q

Describe the concept of metabolic programming in development of obesity

A

Concept that environmental and nutritional influences during critical periods of development can have an effect of an individuals predisposition to obesity

22
Q

What is meant by bonafide endocrine organ?

A

An organ in which defects can originate in the tissue iteself/ ability to communicate with brain/ downstream events

23
Q

Where is the main site of thermogenesis

A

Brown adipose tissue

24
Q

Are people with an apple or a pear shaped body at a higher risk of a weight related health problem?

A

Apple

25
Q

What are the key features in linking obesity and type 2 diabetes (4)

A

Chronic inflammation
Altered adipokine levels (high leptin)
Breakdown of fat metabolism
Breakdown of regulation of glucose metabolism

26
Q

Who is non alcoholic fatty liver disease

A

Build up of fat in the liver

27
Q

2 ways to prevent obesity

A

Inform people about lifestyle

Promote/develop non-obesogenic environment

28
Q

Is diet or exercise more important in weight loss

A

Diet

29
Q

Mechanism of action of phentermine

A

NE transporter inhibitor

Appetite suppresion mediated by activation of POMC

30
Q

Mechanism of orlistat

A

Gastric and pancreatic lipase inhibitor

31
Q

Mechanism of action of lorcaserin

A

Selective 5-HT2c agonist

32
Q

Mechanism of liraglutide

A

GLP-1 agonist

33
Q

What is the main prescribed form of weight loss drug in UK

A

Orlistat

34
Q

When should weight loss surgery performed laparoscopically

A 
Morbid obesity (BMI>40kg/m2)
BMI> 35kh/m2 and obesity related complications
35
Q

Aim of restrictive surgery procedures

A

Restrict ability for stomach to contain food

36
Q

Aim of malabsorptive procedures

A

Reduce ability to absorb nutrients causes nutrient deficiencies, malnutrition and sometimes anastomic leaks

MET 2 (32 decks)

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