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Pathophysiology and Pharmacology 2 > Obesity > Flashcards

Obesity Flashcards

1
Q

Obesity prevelance

A

33% 250 billion spent

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2
Q

obesity contributing factors

A 
genetics
behavioral
metabolic
environmental
socioeconomic
physical inactivity/sedentary lifestyle
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3
Q

healthy people 2030

A

^ office visits by adults who have obesity
^ consumption of fruits/veggies, dark/green/red/orange veggies/grains/calcium/potassium/vitamin D age 2+
Screen time below 2H/day

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4
Q

caloric intake vs caloric use

A

hunger & satiety r/t appetite
vs
controlled by metabolic rate (thyroid hormones/activity levels)

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5
Q

short-term appetite regulators

A

oral receptors
GI tract hormones
stomach stretching

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6
Q

intermediate/long-term appetite regulators

A

increased BG
adipose leptin
increased blood ketoacids

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7
Q

Hypothalamus

A

regulates appetite/energy homeostasis
input from peripheral organs
ARC (arcuate nucleus)
also cognitive/memory/feeling components

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8
Q

Adipose Tissue

A 
endocrine organ 
makes adipocytokines
white fat (adults & insulation/cushioning/hormones)
brown fat (newborns & thermogenic)
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9
Q

Adipocytokines

A

leptin (increases w/ adipose creation, causes satiety)

Adiponectin (decreases with increased adipose, regulates insulin sensitivity)

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10
Q

Leptin

A

inhibits appetite @ hypothalamic

reduces peptides that increase intake

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11
Q

cholecystokinin

A

stimulates digestion of fat/portein

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12
Q

glucagon-like peptide-1

A

incretin

enhances seretion of insulin

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13
Q

peptide YY

A

reduces appetite

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14
Q

ghrelin

A

“hunger hormone”

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15
Q

adiponectin

A

glucose regulation

fatty acid oxidation

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16
Q

genetic obesity

A

monogenic or polygenic
disrupts leptin-melanocotrin pathway
prader-willi

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17
Q

inflammation & obesity

A

adipocyte become lipid laden & hypertrophied
cellular stress occurs
adipose tissues produce chemicals that trigger inflammation

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18
Q

Insulin resistance

A

impaired glucose transport into insulin sensitive cells
more insulin needed to maintain normal blood glucose
hyperinsulinemia (r/t obesity, impaired glucose tolerance, ^ weight/BMI)

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19
Q

Visceral Adiposity

A

central fat distribution
increases LDL (increased risk for heart disease)
increased body weight (increased cardiac workload, risk for cardiomyopathy and heart failure)

20
Q

Reactive oxygen species

A

highly reactive/unstable molecules
damage other molecules (proteins/lipid/cho/DNA)
impair cell membrane receptors
signaling pathways

21
Q

oxidative stress

A

due to increased ROS and decreased antioxidant
defenses
can begin in childhood and lead to progressive damage

22
Q

antioxidant defenses

A

vitamin E/C
plant flavonoids (bright fruits/veggies)
enzymes (superoxide dismutase & glutathione peroxidase)

23
Q

Oxidative stress r/t obesity

A 
hyperglycemia
increased ROS production
decreased antioxidants
chronic inflammation 
increased lipids
hyperleptinemia
24
Q

metabolic syndrome

A

insulin resistance
increased visceral fat
increased release of free fatty acids (impairs hepatic insulin clearance)
alterations in peripheral metabolism

25
Q

metabolic syndrome criteria

A 
need 3/5
increased waist circumference (M 40+ F 35+)
elevated triglycerides (150+)
elevated BP (130/85 +)
elevated fasting glucose (100+)
reduced HDL (M <40 F <50)
26
Q

obesity health risks

A 
reduced quality of life
shortened lifespan 
diabetes
orthopedic problems
liver disease
endocrine changes
htn
heart disease
osa
gallbladder disease
musculoskeletal/skin disorders
cancer
27
Q

maternal obesity considerations

A 
pregnancy induced HTN
gestational diabetes
thromboembolism
respiratory complications
cardiovascular complications
preterm delivery
cesarean delivery
28
Q

Phentermine

A 
amphetamine-like
short-term use
BMI 30+ or 27 w/ RF
requires behavioral modifications
BBW: increased risk of pulmonary HTN
29
Q

obesity tx

A

surgery
gastric banding/gastric bypass (clipping/cutting stomach but can grow back)
lifestyle
some meds

30
Q

obesity med history

A 
bad
addictive
heart valve defects
stroke
cardiac events
31
Q

Orlistat (alli, xenical)

A

lipase inhibitors
blocks absorption of fats in small intestine
also blocks fat-soluble vitamins/warfarin
small decrease in weight
must take 1H before meal w/ fats
SE: flatus, oily stool, fecal incontinence, ab pain, headache

32
Q

Anorexiants

A

appetite suppressants

33
Q

diethylpropion

A

similar to amphetamine
limited to 12 weeks (tolerance)
CNS effects

34
Q

phentermine/topiramate

A

effects hypothalamus
decreases appetite
CNS side effects
seizures if discontinued quickly

35
Q

locaserin

A

effects hypothlamus

causes feeling of fullness

36
Q

bupropion and naltrexone

A

increases dopamine = decreased appetite

can cause suicidal behavior

37
Q

malnutrition

A

acute/chronic illnesses unable to use nutrients

38
Q

under-nutrition

A 
can't intake nutrients
old age
HIV-AIDS
alcoholism 
burns
cancer 
IBD
eating disorders
GI disorders
surgery
trauma
39
Q

malnutrition/under nutrition s/s

A

generalized weakness
muscle wasting
loss of subcutaneous fat
dry/flaky skin

40
Q

enteral nutrition

A

admin via GI tract
oral or feeding tube (NJ/NG/gastostomy)
may still be eating

41
Q

polymeric

A

undernourished w/ functioning GI tract

42
Q

elemental (monomeric)

A

malabsorption disorder

43
Q

semi-elemental (oligomeric)

A

easily obsorbed

44
Q

modular

A

disease specific w/ single nutrient

45
Q

TPN

A

requires CVC

check BS and triglyceride levels

46
Q

Maramus

A

too few calories and too little protein
affects somatic more
s/s: progressive loss of muscle/fat stores, wasted appearance, wrinkles, sparse hair, low HR/BP/temp, diarrhea, impaired immune system
like COPD CHF cancer and HIV

47
Q

Kwashiorkor

A 
adequate calories too little protein
more severe
affects visceral more
hypoalbuminemia (=edema)
desquamating skin (peeling)
reddish hair
muscle wasting
SQ fat normal
hepatomegaly
distended abdomen
tachycardia
r/t trauma, burns, spesis

Pathophysiology and Pharmacology 2 (27 decks)

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