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Endocrine-Week 3/4 > Weight & Obesity > Flashcards

Weight & Obesity Flashcards

1
Q

Chemical produced by fat cells; binds to Hypothalamus to simulate SATIETY via activation of POMC neurons inhibiting MCH neurons

A

Leptin

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2
Q

Leptin works to (stimulate/suppress) appetite via (NPY/POMC) neurons

A

neurons in the lateral Hypothalamus)

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3
Q

Chemical produced by GI system; binds to Hypothalamus to stimulate HUNGER via activation of NPY neurons

A

Ghrelin

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4
Q

Ghrelin works to (stimulate/suppress) appetite via (NPY/POMC) neurons

A

Stimulate; NPY

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5
Q

Leptin is produced by (fat/GI tract)

A

Fat

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6
Q

Ghrelin is produced by (fat/GI tract)

A

GI tract

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7
Q

Leptin deficiency is responsible for most cases of obesity (True or False)

A

False; thought to be Leptin resistance

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8
Q

Which cells in the Hypothalamus respond to Letin (inhibited) and Ghrelin (activated)

A

NPY cells

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9
Q

Chemical synthesized in the BRAIN from polyunsaturated fats to stimulate food intake; may be cause of “munchie” with marijuana use

A

Endocannabinoids

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10
Q

How to calculate BMI

A

weight (kg) / height (m^2)

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11
Q

Normal BMI range

A

18.5-25

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12
Q

Shortcomings of BMI

A

Very muscular person (falsely high)
Older (more fat and shorter)
Female (more body fat)

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13
Q

People with a (apple/pear) fat distribution are at an inc. risk for Type 2 Diabetes

A

Apple (fat deposition is above waist)

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14
Q

What are the two largest energy stores in the body?

A

Adipose

Tissue protein

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15
Q

About ____% of energy breakdown is lost in the form of heat

A

80

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16
Q

We get ___ kcal of energy per gram of carbohydrate

A

4

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17
Q

We get _____ kcal of energy per gram of fat

A

9

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18
Q

We get _____ kcal of energy per gram of alcohol

A

7

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19
Q

What is Metabolic Adaptation?

A

With increased activity, there is a slowing of RESTING metabolic rate as a sort of “compensatory” mechanism; thought to contribute to weight regain

20
Q

Structure in the Hypothalamus responsible for monitoring energy signals, such as nutrients, food intake, fat stores, etc.; composed of Orexigenic (appetite stimulating) and Anorexigenic (appetite suppressing) neurons

A

Arcuate Nucleus

21
Q

Orexigenic neurons are (NPY/POMC) neurons in the Hypothalamus that function to (stimulate/suppress) appetite

A

NPY; stimulate

22
Q

Anorexigenic neurons are (NPY/POMC) neurons in the Hypothalamus that function to (stimulate/suppress) appetite

A

POMC; suppress

23
Q

Part of the Hypothalamus that receives inputs from the Arcuate Nucleus; activated by NPY cells and inhibited by POMC cells

A

Lateral Hypothalamus

24
Q

“Classic” satiety signal from duodenal I-cells; secreted in response to lipids and proteins; reduces hunger and promotes a feeling of fullness

A

Cholecystokinin (CCK)

25
Q

Cholecystokinin is secreted from _____-cells

A

I

26
Q

Satiety signal from intestinal L-cells; inhibits GI motility and secretions, causing “ileal brake”; stimulates Insulin secretion and inhibits glucagon release

A

Glucagon-like Peptide-1 (GLP-1)

27
Q

GLP-1 is secreted from ______-cells

A

L

28
Q

Neurotransmitters that help control food intake (3 total)

A

Dopamine
NorEpi
Serotonin

*all work to suppress appetite

29
Q

Most common cause of MONOgenic obesity

A

MC4-R deficiency (can’t receive inhibitory signals from POMC)

30
Q

Best predictors for long-term weight loss maintenance

A 
Motivational tools
Regular exercise
Eat breakfast every day
Reduce calorie intake
Regular weight monitoring
31
Q

The Mortality of obesity increases rapidly after what BMI

A

> 30

32
Q

A 20 pound weight loss is associated with what reductions morbidity/mortality?

A

20% lower death

~30-40% lower death from CVD, DM or Cancer

33
Q

Medications account for ___% of obesity in the U.S. due to side effect profiles

A

10

*so be sure to ask your overweight patients about medications

34
Q

Categories of drugs that are notorious for weight gain

A

Anti-psychotics (Risperidone, Clozapine, etc.)
Anti-depressants (Mirtazapine, Paroxetine, etc.)
Anti-diabetics (Insulin, Sulfonylureas, etc.)
Glucocorticoids

35
Q

At what BMI range do we tend to start treating with medications in addition to diet and exercise?

A

> 30

*>35 we also consider surgery

36
Q

What is a realistic weight loss goal for obese patients?

A

5-10% loss (by next visit)

37
Q

Patients should exercise for _________ minutes per week, especially if they wish to lose weight

A

> 150

38
Q

Behavioral changes that can help a patient lose weight

A

Eat only at table (no TV)
Small plates
No seconds
Only 3 meals per day

39
Q

Drugs that are APPROVED for weight loss

A 
Phentermine (short term)
Orlistat
Topiramate
Lorcaserin
Bupropion/Naltrexone
40
Q

MOA for Phentermine (weight loss drug) (short term)

A

Stimulant related to amphetamine; dec. appetite and inc. satiety

41
Q

MOA for Orlistat (weight loss drug) (long term)

A

Inhibits pancreatic lipase, dec. fat absorption

*also helps lipid profiles

42
Q

Side Effects of Orlistat (weight loss drug) (long term)

A

assy
Steatorrhea
Vitamin deficiencies (A, D, E and K)

43
Q

MOA of Lorcaserin (weight loss drug) (long term)

A

5HT2-C serotonin receptor agonist; dec. appetite and inc. satiety

44
Q

What BMI range would you begin to consider surgery?

A

> 35

45
Q

Examples of gastric surgeries used for weight loss

A 
Lap Band (around cardiac sphincter)
Gastrectomy
Gastric Bypass
Biliopancreatic Diversion (empty into ileum, delaying chemical digestion)
46
Q

Supplements that patients will need after any Gastric surgery

A 
Vitamin B1 (thiamine)
Vitamin B12
Vitamin D
Folate
Iron
Calcium Citrate

Endocrine-Week 3/4 (9 decks)

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