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Y2 GASTRO > disorders of appetite > Flashcards

disorders of appetite Flashcards

1
Q

define polydipsia?

A

excessive thirst

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2
Q

define adipsia?

A

inappropriate lack of thirst with consequent failure to drink in order to correct hyperosmolality

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3
Q

define anorexia?

A

loss of appetite for food

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4
Q

define obesity

A

excess fat accumulation that presents a risk to health

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5
Q

What is the name of the hormone responsible for the regulation of Osmolality?

A

ADH antidiuretic hormone

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6
Q

How does ADH work and where is it stored?

A

acts on collecting ducts of kidneys to regulate the volume and osmolality of urine
when plasma ADH is low a large volume of urine is excreted
posterior pituitary

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7
Q

If the plasma concentration of ADH is low will there be a water diuresis or an anti-diuresis?

A

diuresis

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8
Q

Which regions are sensory osmoreceptors found in the hypothalamus?

A

Organum vasculosum of the laminate terminalis
Subfornical organ

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9
Q

What is the most common disorder of thirst?

A

Secondary polydipsia

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10
Q

List at least 3 causes of primary polydipsia

A

Mental illness - psychogenic polydipsia, mood disorders such as depression and anxiety, anorexia, drug use
Brain injury - trauma
Organic brain damage - central pontine myelinolysis, Alzheimer’s disease

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11
Q

What is secondary polydipsia?

A

Medical issues that disrupt any step in osmoregulation or alter ADH can cause secondary polydipsia

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12
Q

What are the two types of disorders of thirst?

A

Polydipsic - primary or secondary
Adipsic - primary or secondary

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13
Q

What chronic medical conditions can cause secondary polydipsia?

A

Diabetes insipidus and mellitus
Acute kidney failure
Conns syndrome
Addisons disease
Sickle cell anaemia

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14
Q

What medications can cause secondary polydipsia?

A

Diuretics• Laxatives- Both result in dehydration• Antidepressants

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15
Q

What illnesses can cause dehydration leading to secondary polydipsia

A

Dehydration• Acute illness• Sweating• Fevers• Vomiting• Diarrhoea• Underhydration

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16
Q

Why is polydipsia a problem?

A

drinking too much water can upset the electrolyte balance in the body-hyponatraemia

17
Q

What can hyponatraemia as a result of polydipsia lead to?

A

• Kidney and bone damage
• Headache
• Nausea
• Cramps
• Slow reflexes
• Slurred speech
• Low energy
• Confusion
• Seizures

18
Q

What is the mechanism of adipsia?

A

Increased osmolality of urine, leading to stimulated secretion of ADH, water retention, sensation of thirst decrease

19
Q

What are the different categorisations of adipsia?

A

Type A - most common (essential hyponatraemia)
Type B
Type C
Type D

20
Q

List some examples of eating disorders?

A

Binge eating disorder
Anorexia nervosa
Bulimia nervosa
Pica
Rumination syndrome
Avoidant/ restrictive food intake disorder

21
Q

what BMI is classed as underweight?

A

Below 18.5

22
Q

What BMI is defined as the healthy weight range?

A

18.5 - 24.9

23
Q

What BMI is classed as overweight?

A

25-29.9

24
Q

What BMI is categorised as class 1 obesity?

A

30-35

25
Q

What BMI is classed as type 2 obesity?

A

35-40

26
Q

What BMI is classed as type 3 obesity?

A

40+

27
Q

What are the signs and symptoms associated with anorexia nervosa?

A

Low BMI, continuous weight loss, amenorrhea, halitosis, mood swings, dry hair, skin & hair thinning

28
Q

What are the different possible causes of anorexia nervosa?

A

Genetic, environmental, psychological, sociological

29
Q

Q: Mr Thomas is a 45 year old with significant abdominal obesity and T2DM. Has tried dieting before without success, his BMI is 39. What therapy would you recommend?

A

Gastric bypass & sleeve gastrectomy

30
Q

List some comorbidities associated with obesity?

A

Depression
Sleep apnoea
Stroke
MI
HTN
diabetes
Peripheral vascular disease
Gout
Osteoarthritis
Bowel and other cancer

31
Q

What are the treatment options for obesity?

A

Life-style modification> Diet + Exercise• Surgical treatment> gastric bypass & sleeve gastrectomy> for people with a > BMI 40 or 35+ comorbidities> WL 5 yrs after BS: 30% - 35%> reduction of all cause mortality & morbidity after BS

32
Q

What are the surgical treatments of obesity?

A

People with a> BMI 40 or 35+comorbidities
• Various procedures
• Most common Roux-en-Ygastric bypass & sleeve gastrectomy
• Weight loss 5 yrs after BS: 30% - 35%
• Remission of comorbidities
> Diabetes (80%)
> OSA (80%-85%)

33
Q

What hormonal changes are often seen after bariatric surgery?

A

ghrelin reduces - reduced hunger
• GLP1, GLP2 & PPY increases - increased insulin, reduced glucagon, increased satiety

Y2 GASTRO (10 decks)

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