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Pathophysiology > Obesity and Cardiovascular System I/II > Flashcards

Obesity and Cardiovascular System I/II Flashcards

1
Q

Which two hormones are secreted by adipose tissue?

A

Adiponectin and Leptin

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2
Q

____ is synthesized predominantly by adipocytes but also by skeletal
muscle, endothelial cells, and cardiomyocytes

A

Adiponectin

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3
Q

True or False: The more adiponectin one has, the less body fat one tends to have

A

True

Inverse correlation with insulin resistance and obesity…

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4
Q

Adiponectin binds to ____ Type I, III, and V in vessels

A

Collagen

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5
Q

True or False: More adiponectin is associated with increased insulin sensitivity

A

True
- Has anti-diabetic effects

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6
Q

Three main functions of adiponectin?

A
  1. Anti-atherogenic
  2. Anti-inflammation
  3. Anti-diabetic
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7
Q

What four ways does adiponectin affect the liver?

A
  1. Increased insulin sensitivity
  2. Decreased glucose output
  3. Decreased FFA influx
  4. Increased B-ox
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8
Q

How does adiponectin affect the skeletal muscle?

A
  1. Increases beta oxidation
  2. Promotes glucose uptake
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9
Q

How does adiponectin affect blood vessels?

A
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10
Q

True or False: Adiponectin has an indirect anti-inflammatory effect

A

True

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11
Q

True or False: Adiponectin reduces glucose concentration in plasma (therefore: has hypoglycemic effects)

A

True
- most important effect

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12
Q

How does Adiponectin promote vessel health (in other words: stop endothelial dysfunction)?

A
  1. Increased NO/eNOS
  2. Decreased apoptosis and ROS formation
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13
Q

True or False: If there is plaque initiation and progression (atherosclerosis), Adiponectin will decreased TNF-a and IL-8 levels

A

True

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14
Q

True or False: Adiponectin only prevents against atherosclerosis at early stages of atherosclerosis

A

False - all stages

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15
Q

How does adiponectin protect at later stages of atherosclerosis?

A

Decreased thrombus formation and fibrous thickening; prevents rupture

Increases TIMP-1

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16
Q

____ is regulated by energy level, food intake, several hormones and various
inflammatory mediators. It provides a functional link between the immune system and energy
homoeostasis.
A. Leptin
B. Adiponectin

A

A. Leptin

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17
Q

Leptin acts centrally on the ____ to reduce ____ and increase
____

A

hypothalamus (type II-R) ; food intake; energy utilization

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18
Q

True or False: Levels of leptin correlated directly with mass of white adipose tissue

A

True

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19
Q

True or False: Hyperleptinaemia is associated with atherosclerosis, hypertension and
metabolic syndrome

A

True

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20
Q

True or False: Leptin & Adiponectin have same dependence on body fat

A

False - opposite dependence on body fat

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21
Q
A
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22
Q

In leptin sensitive individuals, leptin leads to a decrease in which four factors?

A
  1. fat storage
  2. TG content (increases FA oxidation)
  3. Activity/expression of lipogenic enzymes
  4. Lipogenic activity of insulin (favors lipolysis)
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23
Q

In leptin sensitive individuals, there is an increased of….

A
  1. Sympathetic mediated energy expenditure
  2. Expression of uncoupling proteins (important for brown tissue)
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24
Q

True or False: Adiponectin activates PKA in muscle and liver

A

False - leptin does this

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25
How does leptin affect ATP-consuming anabolism and ATP -producing catabolism?
Decreases ATP-consuming anabolism Increases ATP-producing catabolism
26
Which three processes are activated when there is reduced Leptin levels?
1. B-oxidation 2. Glucose transport/glycolysis 3.Mitochondrial biogenesis - Increase catabolism
27
If there is energy restriction, there is decrease in fat mass and leptin. As a result, there's less energy available for what three things? More energy available for which two things?
Less energy for: 1. Reproduction 2. Growth 3. Anabolism More energy for: 1. Maintenance of soma 2. Adrenalcortical axis
28
True or False: Adiponectin shows an asymmetrical biological response
False - leptin does
29
Reductions in leptin induce ___ effect than increases in leptin A. smaller b. bigger
b. bigger
30
True or False: Excess Leptin is associated with decreased energy expenditure and increased fat storage
False - increased leptin is associated with... 1. Decreased fat storage 2. Increased energy expenditure
31
True or False: Leptin can pass through BBB
True
32
___ opposes release of Insulin
Leptin
33
When leptin binds to its receptor, it inhibits ___ entry, leading to less ___; KATP is not blocked; and membrane is ____
glucose; ATP; hyperpolarized Less exocytosis of insulin - how leptin is anti-glycemic
34
True or False: Insulin promotes development of adipose tissue
True
35
Insulin promotes synthesis of ___ and inhibits ____
TG; lipolysis
36
If leptin acts on insulin, how does this affect development of adipose tissue?
Reduced dev of adipose tissue
37
A leptin sensitive person is... A. Obese B. Lean C. Anorexic
B. Lean
38
What can occur if a person has a Type II Leptin receptor mutation in the hypothalamus?
1. Overweight 2. Beta cells in pancreas are not inhibited (therefore: insulin is made w/o restraint) 3. Increase body fat
39
True or False: There appears to be correlation between leptin and insulin resistance
True
40
True or False: Metabolic syndrome, obesity, and diabetes are associated with insulin resistance
True
41
How does Leptin increase risk of Atherosclerosis at stage 1: endothelial dysfunction?
Increases leukocytes, macrophages, ROS
42
True or False: Leptin can cause release of inflammatory factors (IL2 and 6, TNF-a) and, ultimately, encourage plaque initiation and progression
True
43
True or False: Leptin increases vascular smooth muscle hypertrophy and proliferation
True - as a result, leptin increases CO
44
Compare and contrast leptin and adiponectin:
45
Name features of metabolic syndrome:
1. Abdominal obesity 2. Elevated TG (high FA from adipose tissue) 3. Decreased HDL (increase LDL) 4. Insulin resistance* 5. Increased coagulation - vasoactive factors released from adipose tissue 6. Increased BP
46
47
True or False: Insulin resistance leads to excess insulin
True
48
What are the affects of Hyperinsulinemia on - Insulin-Sex Hormone Axis? - Insulin -IGF Axis? How does this favor tumor development?
49
True or False: Obesity leads to adipocyte hypertrophy and elevated leptin (accompanied by downregulation of adiponectin)
True
50
ER stress in obesity can lead to production of inflammatory cytokines, which can lead to failure of ____
differentiation
51
How does adipocyte hypertrophy affect capillary density vasoconstriction?
Decreases, leads to altered lipid metabolism
52
Adipocyte hypertrophy leads to hypoxia, which can lead to ____secretion and dysfunction of ____, an organelle
chemokine; mitochondria
53
Both ___ and ___lead to chemokine secretion
hypoxia; adipocyte hypertrophy
54
True or False: Obesity is associated with adipose tissue vasodilation
False - adipose tissue vasoconstriction
55
True or False: Adipose tissue hypoxia can lead to inflammation
True
56
Via TNF-a, inflammation can cause ____
insulin resistance
57
Obesity can lead to increased synthesis of adipokines, which can increased ___, leading to ____
insulin; T2DM
58
As one gets fatter, they have expansion in skeletal m., viscera, in skin. How does this affect O2 consumption and CO?
Both increase
59
True or False: As you increase CO, you decreased Central Venous Pressure
True (Cardiac Function Curve)
60
In obesity, one can have increased left ventricular filling. How does this volume overload affect chamber dilation, myocardial wall stress/tension, and radius?
Increased left ventricular filling... - Left chamber dilation - Increased wall tension
61
True or False: Increased left ventricular filling, as seen in obesity, stimulates development of eccentric ventricular hypertrophy
True
62
Why does increased left ventricular filling lead to elongation of myocytes?
Synthesis of new sarcomeres in series with the old
63
In increased left ventricular filling, ___ helps to reduce wall stress
hypertrophy
64
How does eccentric hypertrophy affect ventricular compliance?
Decreases it - Note: Increased in EDV leads to eccentric hypertrophy
65
How do compliance, volume/flow contribute to diastolic dysfunction?
Decreased compliance, increased volume/flow lead to diastolic dysfunction
66
Why is hypertrophy good? bad?
Bad = reduces compliance Good = alleviates wall stress/tesnsion
67
How does diastolic dysfunction affect: a. LVED pressure b. PA pressure c. capillary pressure
Increases all of the above
68
If hypertrophy does not keep pace with chamber dilation, what can occur?
Systolic dysfunction
69
How does systolic dysfunction develop?
Increased wall stress leads to decreased ventricular contractility = systolic dysfunction
70
True or False: In Obesity, Left Ventricular Hypertrophy leads to expanded extravascular volume and decreased preload, leading to CONCENTRIC left ventricular hypertrophy
False - In Obesity, Left Ventricular Hypertrophy leads to expanded INTRAvascular volume and INCREASE preload, leading to ECCENTRIC left ventricular hypertrophy
71
How can you develop concentric left ventricular hypertrophy?
Increased TPR leads to HTN => Increased Afterload
72
True or False: Eccentric-concentric left ventricular hypertrophy can occur in obese patients
True

Pathophysiology (26 decks)

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