Obesity I and II

Question 1

energy homeostasis is regulated by what mechanisms?

Answer 1

1. brain
2. GI tract
3. adipose tissue

Question 2

what are the satiety hormones?

Answer 2

1. cck
2. pyy
3. glp-1
4. leptin

Question 3

leptin is released by what tissue?

Answer 3

fat

Question 4

where does leptin bind?

Answer 4

leptin receptors in hypothalamus

Question 5

where is CCK produced?

Answer 5

small intestine

Question 6

PYY is released by what organ?

Answer 6

pancreas PYY

Question 7

PYY is released in response to elevated levels of what nutrient?

Answer 7

blood glucose

Question 8

what are the roles of gpl-1?

Answer 8

1. increases insulin secretion
2. increases insulin sensitivity
3. decreases glucagon secretion
4. inhibits acid secretion and gastric emptying

Question 9

where is ghrelin produced?

Answer 9

cells lining fundus of stomach and epsilon cells of pancreas

Question 10

what is considered successful weight loss?

Answer 10

losing 10% of initial body weight and keeping it off for at least one year

Question 11

what are the central concepts of motivational interviewing?

Answer 11

identification, evaluation, and resolution of ambivalence

Question 12

what is the mechanism for orlistat?

Answer 12

lipase inhibitor that blocks fat absorption from the gastric / duodenal mucosa

Question 13

what is the only obesity medication approved for adolescent use?

Answer 13

orlistat

Question 14

what is the function of phentermine?

Answer 14

appetite suppression

Question 15

what is the function of topiramate?

Answer 15

anticonvulsant, appetite suppression, and prolonging of fullness

Question 16

what is the treatment for stomal ulceration?

Answer 16

PPIs, carafate, abx if infected

Question 17

what are the symptoms of dumping syndrome?

Answer 17

1. hypotension
2. tachycardia
3. syncope
4. flushing
5. abdominal cramping, diarrhea
6. nausea and vomiting

Question 18

what is the cause and mechanism of dumping syndrome?

Answer 18

simple sugar ingestion leads to osmotic overload and fluid shift from blood to intestine

Question 19

what are the nutritional implications of bariatric surgery?

Answer 19

1. iron deficiency anemia
2. B12 deficiency
3. folate deficiency
4. calcium and vitamin D deficiency

Question 20

what is the treatment for iron deficiency?

Answer 20

oral ferrous sulfate or ferrous gluconate

Question 21

what is the mechanism for iron deficiency following roux-en-y gastric bypass?

Answer 21

1. low acid levels prevent iron cleavage from food
2. no nutrient exposure to duodenum or proximal jejunum
3. decrease in iron rich food due to intolerance

Question 22

what is the cause of B12 deficiency?

Answer 22

lack of HCl and pepsin in stomach - prevents B12 cleavage from food and affects secretion of intrinsic factor

Question 23

what is required for folate absorption?

Answer 23

B12