SM_148b: Pathophysiology of Obesity

Question 1

Obesity is ____

Answer 1

Obesity is a condition characterized by the excessive accumulation and storage of fat in the body

• An amount sufficiently large to cause reduced health and longevity
• Abnormal or excessive fat accumulation that presents a risk to health

Question 2

____ is a practical and useful determinant of excess body fat and risk of morbidity and mortality

Answer 2

BMI is a practical and useful determinant of excess body fat and risk of morbidity and mortality

Question 3

Obesity affects ____, ____, ____, ____, ____, ____, ____, ____, and ____

Answer 3

Obesity affects the brain, lungs, heart, liver, gall bladder, uterus/ovaries, joints, skin, and others

Question 4

Describe why obesity is pathological

Answer 4

Obesity is pathological because

• Release of adipokines (lipotoxicity)
• Increased mechanical burden
• Increased abdominal pressure
• Increased abdominal pressure
• Increased respiratory burden
• Fluid and hemodynamic changes / CV burden
• Dietary and physical activity changes associated with obesity

Question 5

Adipose tissue is an ____ organ

Answer 5

Adipose tissue is an endocrine organ

• Secretes leptin, fatty acids, adiponectin, TNF-a, PAI-1, and cytokines

Question 6

Fat is either ____ or ____

Answer 6

Fat is either visceral or subcutaneous

Question 7

Waist circumference ____ and insulin action ____ with increasing visceral adipose tissue

Answer 7

Waist circumference increases and insulin action decreases with increasing visceral adipose tissue

Question 8

Central adiposity results in ____ that cause ____, ____, and ____

Answer 8

Central adiposity results in secretion of adipocyte factors that cause dyslipidemia, dysfunction, and insulin resistance

Question 9

Products of fat tissue result in ____ which spur comorbidities

Answer 9

Products of fat tissue result in lipotoxicity which spur comorbidities

Question 10

Obese adipose tissue is characterized by ____ that promotes ____

Answer 10

Obese adipose tissue is characterized by macrophage infiltration that promotes inflammation

Question 11

Pathological adipose tissue expansion results in ____

Answer 11

Pathological adipose tissue expansion results in hypoxia

Question 12

Removal of subcutaneous fat ___ cardiovascular risk factors, inflammatory markers, or insulin resistance

Answer 12

Removal of subcutaneous fat has no effect on cardiovascular risk factors, inflammatory markers, or insulin resistance

Question 13

Describe criteria for metabolic syndrome

Answer 13

Metabolic syndrome: need 3

• Elevated waist circumference
• Elevated triglycerides
• Reduced HDL-c
• Elevated BP
• Elevated fasting glucose

Question 14

Central obesity promotes ____ which is associated with ____

Answer 14

Central obesity promotes insulin resistance which is associated with atherosclerosis

Question 16

Lipid overflow (ectopic fat) can result in ____

Answer 16

Lipid overflow (ectopic fat) can result in metabolic syndrome

Question 17

____ results in hepatosteatosis and cardiac steatosis

Answer 17

Overflow of ectopic fat results in hepatosteatosis and cardiac steatosis

Question 18

Abdominal obesity (high waist measurement) involves ____

Answer 18

Abdominal obesity (high waist measurement) involves visceral adipose tissue

Question 19

Obesity is associated with ____

Answer 19

Obesity is associated with back pain

• Blount’s disease: childhood obesity associated with acute medial angulation (breaking) of the proximal medial metaphysis of the tibia

Question 20

Obesity is associated with ____

Answer 20

Obesity is associated with GERD

Question 21

Obesity reduces diaphragmatic movement, causing ___

Answer 21

Obesity reduces diaphragmatic movement, causing decreased FRC

• Leads to all sorts of obesity issues

Question 22

Pickwickian syndrome involves ____ and ____

Answer 22

Pickwickian syndrome involves obesity hypoventilation syndrome and obstructive sleep apnea

Question 23

Obesity precipitates ____, ____, and ____

Answer 23

Obesity precipitates HTN, left ventricular hypertrophy (eccentric or concentric), and peripheral venous stasis (ulceration)