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Muscle Physiology > Pathophysiology Three > Flashcards

Pathophysiology Three Flashcards

1
Q

what is cachexia?

A
  • weight loss, wasting of muscle, loss of appetite, and general debility that can occur during a chronic disease
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2
Q

what are some diseases associated with cachexia

A
  • cancer
  • COPD
  • DHF
  • chronic kidney disease
  • chronic inflammatory diseases (HIV/AIDs, rheumatoid arthritis, etc)
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3
Q

sarcopenia

A

age related loss of muscle mass, strength and function

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4
Q

can you have sarcopenia and cachexia at the same time

A

yes

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5
Q

cachexia reduces ______ and ______ of life

A

quality
length

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6
Q

T or F: cachexia increases chemo toxicity and decreases efficacy

A

T

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7
Q

t or f: cachexia increases post-surgical complications and increases medical costs

A

T

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8
Q

what is the #1, 2, and 3 causes of death in the US

A

1 - heart disease
2 - cancer
3 - COPD

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9
Q

COPD cachexia develops in ________% of patients

A

20-40

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10
Q

what is a major cause of cachexia

A

cytokine excess

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11
Q

______ energy expenditure and ________ energy intake are hallmarks of cachexia

A

increased
decreased

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12
Q

as a result of negative energy balance in cachexia, when you add inflammation you get ________ muscle protein synthesis and _____ muscle protein degradation

A

decreased
increased

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13
Q

can you come back from refractory cachexia?

A

no. you may be able to go from cachexia to precachexia though

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14
Q

what cancer has the highest frequency of weight loss?

A

pancreatic or gastric cancer

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15
Q

what is the key to prevent cachexia?

A

early detection

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16
Q

more weight lost in cachexia = more ________ lost

A

muscle
*not just losing fat!

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17
Q

T or F: administering exogenous IGF-1 prevented cachexia

A

F
IGF-1 decreased in those with cancer

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18
Q

what is PIF?

A

proteolysis inducing factor

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19
Q

why/what patients is PIF important for

A
  • important in cancer, burns, and sepsis patients
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20
Q

what does PIF activate

A

increases calpain activity
- calpains chop up scaffolding for sarcomeres and allow proteins to be exposed for degradation

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21
Q

studies show increase in __________ activity in gastroc muscle from control mice to mice treated with PIF

A

proteasome

22
Q

More PIF = ______ protein degradation

A

more

23
Q

what is sepsis

A

a potentially life threatening condition that arises when the body’s response to infection causes injury to its own tissues and organs

24
Q

what is septic cachexia

A

when an extreme response to infection destroys muscle tissue

25
Q

who is at risk for septic cachexia

A
  • very young or old
  • immunocompromised (cancer, AIDS, severe burns/injury, pneumonia, meningitis, cellulitis, UTI, ruptured appendix)
26
Q

what are primary causes of muscle weakness and cachexia with sepsis

A
  • muscle function decreased
  • decreased protein synthesis
  • increased protein degradation
  • sattelite cell activity blocked
27
Q

increased TNF-a = _______ force production

A

decreased

28
Q

T or F: sepsis affects all muscle fiber types the same

A

F

29
Q

overall muscle protein synthesis is _______ in sepsis

A

decreased

30
Q

calpains are _____ in sepsis

A

increased

31
Q

T or F: calpains, myofilament release, ubiquitin and proteasome mRNA all increase in sepsis

A

T: calpains release myofilaments so proteasomes can go chop up the myofilaments.

32
Q

T or F: a fast twitch muscle (like EDL) suffers more damage from sepsis than a slow twitch muscle (like soleus)

A

T, type 2 muscles undergo more damage from sepsis than type 1

33
Q

if TNF-a is involved, muscle function and contractile force _______

A

decreases

34
Q

if there is decreased protein synthesis, translation of RNA is _______ and type _____ muscles are effected more than type ______ muscles

A

decreased
2
1

35
Q

increased protein degradation __________ calpain-proteasome system, caspases, and UPS

A

increases

36
Q

what is a neuromusclar disease

A

any condition that affects the structure and/or function of any component of your neuromuscular system including peripheral nerves, NMJ, and muscle fibers

37
Q

what is a mixed UMN/LMN disorder

A

ALS

38
Q

what are some LMN diseases

A

peripheral nerve injury
Gullain-Barre syndrome
chronic inflammatory demyelinating polyneirapthy
SMA
poliomyelitis
charcot-marie-tooth disease

39
Q

what are some diseases at the NMJ

A
  • botulism
  • lambert-eaton myasthenic syndrome (LEMS)
  • nyasthenia gravis (MG)
40
Q

ALS

A
  • progressive neurodegenerative disease
  • cause muscles to weaken, twitch, and waste
  • normal cognition
  • eventually lose voluntary movement
  • fatal (from respiratory failure)
  • no cure
41
Q

SMA

A
  • autosomal recessive disorder (mutations to survival motor neuron gene 1)
  • skeletal muscle weakness caused often more severe in the trunk and upper leg/arm than in muscles of hands and feet
  • ALSO: respiratory infections, scoliosis, and joint contractures (chronic shortening of muscles and tendons)
42
Q

Poliomyelitis

A
  • highly infectious viral disease
  • mostly affects children
  • preventable with vaccination
  • in acute forms, causes inflammation of motor neurons oof the spinal cord and brain stem
  • leads to paralysis, muscular atrophy, and often deformity
43
Q

Gullain-Barre syndrome

A
  • caused by immune system attacking PNS
  • rapid onset muscle weakness
  • typically both sides of body affected
  • initial symptoms are changes in sensation or pain often in the back along with muscle weakness, beginning in feet/hands then spreading to arms and upper body
44
Q

chronic inflammatory demyelinating polyneuropathy

A
  • acquired autoimmune disease of PNS characterized by progressive weakness and impaired sensory function in arms and legs
  • symmetric weakness in prox and distal muscles
  • increased incidence with advancing age
45
Q

Myasthenia Gravis

A
  • women <40, men >60
  • autoimmune disease
  • antibodies block, alter, or destroy the ACh receptor/activity
46
Q

what is the main symptom we need to know for MG?

A

drooping eyelid

47
Q

burns induce skeletal muscle _________

A

proteolysis
(muscle wasting/cachexia)

48
Q

burns cause hypermetabolic response which causes increases in…

A

body temp
glycolysis
proteolysis
lipolysis
futile substrate cycling

49
Q

what are some treatments for burn-induced muscle wasting

A
  • GH injections
  • insulin
  • catecholamine antagonists
  • IGH1 and IGH binding
  • anabolic steriods
50
Q

Why is oxandrolone a good steroid to treat burns?

A

it doesnt harm the liver and doesnt cause androgen effects

Muscle Physiology (17 decks)

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