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Semester 1 > Obesity > Flashcards

Obesity Flashcards

1
Q

Describe primary and secondary active transport

A

Primary:

  • uses energy source directly
  • e.g sodium potassium pump
  • obtains energy directly from breakdown of ATP
  • transports both sodium and potassium

Secondary:

  • indirect use of energy store
  • able to go against concentration gradient without breaking down ATP
  • movement of 2 or 3 substances is linked
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2
Q

What causes/maintains resting membrane potential?

A
  1. Plasma membrane as selective controllable barrier (donnan effect)
  2. Sodium potassium pump (3 na out and 2 k in)
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3
Q

How is an action potential generated?

A

Membrane potential set by balance of ion gradients and permeability
Depolarisation (caused by a trigger) upsets the balance
If depolarisation less than 20mV, membrane potential will fall again
If depolarisation is greater than 20mV, threshold level is reached and action potential is generated

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4
Q

Describe the structure of proteins

A

Primary: sequence of amino acids joined by peptide bonds

Secondary: structures are not dependent on the side chain as the H bonds form between carbonyl group of the peptide bond and H atom of another

  • alpha helix: coiling is always clockwise and hydrophobicity determined by side chains
  • beta sheets: occurs when H bonds form between peptide chains that lie alongside each other
  • u turn: consists of 3-4 residues

Tertiary: disulphides, hydrogen, ionic and hydrophobic bonds

Quaternary: acetylation, glycosylation and phosphorylation

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5
Q

Functions of membrane proteins

A 
Junctions 
Enzymes 
Transport 
Recognition
Anchorage 
Transduction
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6
Q

Regulation of glycolysis

A
  1. Hexokinase (catalyses glucose to glucose-6-P)
  2. Phosphofructokinase (catalyses fructose-6-P to fructose-1,6-bisphosphate)
  3. Pyruvate kinase (catalyses phosphopenolpyruvate to pyruvate)

These are three irreversible steps of glycolysis

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7
Q

Citric acid cycle definition and process

A

Common pathway by which all fuel molecules are broken down to co2 and h2o

  1. A 2 carbon molecule (acetyl coa) is condensed with a 4 carbon molecule (oxaloacetate) to form a 6 carbon molecule (citrate)
  2. Citrate is broken down in stages, finally resulting in formation of a new molecule of the original 4 carbon compound
  3. Additional products: 3 NADH, 1 FADH2, 2 co2, 1 GTP
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8
Q

What are the 4 regulatory protein families that are termed receptors?

A
  1. Enzymes
  2. Carrier molecules
  3. Ion channels
  4. Neurotransmitter, hormone or local hormone receptor
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9
Q

Examples and mechanism of action of drug receptor interactions: Ligand-gated ion channels

A

Changes in membrane potential or ionic concentration within cell —> intracellular effects

E.g cholinergic nicotinic receptors

Local anaesthetics

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10
Q

Examples and mechanism of action of drug receptor interactions: G-protein coupled receptors

A

Binding site on Extracellular site and then info transferred through the domains and reaches inside —> allowing cascading. Protein phosphorylation and intracellular effects

E.g alpha and beta adrenoreceptors

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11
Q

Examples and mechanism of action of drug receptor interactions: enzyme linked receptors

A

Protein and receptor phosphorylation –> Intracellular effects

E.g insulin receptors

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12
Q

Examples and mechanism of action of drug receptor interactions: intracellular receptors

A

Protein phosphorylation and altered gene expression

E.g. steroid receptors

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13
Q

What is the equilibrium dissociation constant?

A

The concentration of drug required to occupy 50% of the receptors at equilibrium.

It is a measure of affinity if any one drug for a receptor

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14
Q

Drug affinity and the pd2 value

A

The lower the pd2 value, the greater the affinity that drug has for the receptor

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15
Q

Antagonist classifications

A

Flowchart: 1

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16
Q

2 principles for slowness of implementing the Biopsychosocial approach to primary care

A
  1. Lack of incentives
    - payment schemes
    - clinical guidelines
  2. Work load and competency issues
17
Q

Co-morbidities of obesity

A 
Diabetes 
Hypertension 
CHD 
Respiratory problems
Sleep apnoea 
Non alcoholic fatty liver disease 
Osteoarthritis 
Cancer
18
Q

Different methods of transport across cell membranes

A

UNIPORT

  • simple diffusion
  • facilitated diffusion
  • active transport (primary or secondary)

COTRASPORT

  • symport (both molecules are being moved in the same direction)
  • antiport (both molecules being moved in different directions)
19
Q

Define passive transport

A

Rate of diffusion into the cell = permeability coefficient x conc gradient across membrane

20
Q

Define partition coefficient

A

Partition coefficient gives a measure of how well a substance dissolves in lipid or aqueous phase

21
Q

What is the respiratory chain?

A

Movement of electrons down the respiratory chain generates a H+ ion (pH) gradient across the inner mitochondrial membrane.

This gradient is used to drive ATP synthesis by way of ATP synthase

22
Q

Define pharmacokinetics and pharmacodynamics

A

Pharmacodynamics: what the drug does to the body

Pharmacokinetics: what the body does to the drug

23
Q

What is metabolic syndrome?

A

sometimes under the name insulin resistance:

  • obesity
  • hypertension
  • dyslipidaemia
  • glucose intolerance
  • raised inflammatory markers
  • abnormal blood clotting
24
Q

Stages of atherosclerosis

A
  1. lesion initiation
  2. fatty streak
  3. fibrous plaque
  4. thrombosis
25
Q

What is the prader-willi syndrome?

A
  • Paternal deletion Chromosome 15
  • Profound hyperphagia
  • Hypotonia
  • Delayed sexual maturation
  • Mild to moderate learning difficulties
26
Q

Medications to treat obesity

A
  • orlistat
  • lorcaserin (5-HT2C receptor agonist)
  • phentermine and topiramate
27
Q

Name and relate one recent theoretical model proposed to elucidate the complexity of the biopsychosocial factors in obesity

A

Homeostatic theory of obesity

PRO:
- acknowledges the need to expand from
nutritional homeostasis models to incorporate more complex behavioral processes that influence overeating.
- Raises important issues regarding socioeconomic

CONS:
- undervalues biological aspects of obesity
- is incomplete in addressing obesity
from an integrative biopsychosocial perspective.

28
Q

Classifications of BMI

A

normal: 18.5 - 24.9
overweight: 25-29.9
obese:
class 1 (30-34.9)
class 2 (35-39.9)
class 3 (40 and above)

29
Q

Criteria for pharmacological adjunct to lifestyle: Orlistat

A

BMI ≥28kg/m2 + comorbidities OR BMI ≥ 30kg/m2

AND

  • Lifestyle and behavioural treatment started, evaluated and target weight loss not reached or plateaued
  • In children: <12yrs not recommended; ≥12yrs only if sig. comorbidities

Length of treatment >3 months only if ≥5% weight lost.

30
Q

3 types of bariatric surgery

A

• Restrictive e.g. sleeve gastrectomy or
adjustable gastric band
• Malabsorptive e.g. Jejunal-ileal bypass
• Combination e.g. Roux-en-Y gastric bypass

31
Q

Criteria for bariatric surgery

A

• BMI ≥35 kg/m2 + ≥1 severe comorbidities OR BMI ≥40 kg/m2

AND

• Non-surgical methods completed with no sig improvement in comorbidities

AND

• Fit for surgery / anaesthetic, aware of risks, and committed to long term follow-up

32
Q

What determines the health of a population?

A
  • social/societal characteristics: total ecology
  • genes and biology
  • health behaviours
  • medical care

Semester 1 (13 decks)

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