401 Metabolic Syndrome Flashcards

(46 cards)

1
Q

Harmonising definition of metabolic syndrome

A

3 of the following. Waist circumference more than 94 cm in males of Europoid, African and Middle Eastern more than 90 cm in south Asian more than 85 cm in Japanese; more than 80 cm in females Europoid, African, Middle Eastern, more than 80 cm in South Asian and more than 90 cm in Japanese; Fasting triglyceride more than 150 mg/dl HDL less than 40 mg/dl; SBP more than 130 mmHg DBP more than 85 mmHg, FBS more than 100 mg/dl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

strongly related to insulin resistance and risk of diabetes and CVD

A

intraabdominal circumference

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

key feature of the metabolic syndrome

A

central adiposity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

True or false. No single gene explains the complex phenotype called the metabolic syndrome

A

True.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

most accepted and unifying hypothesis to describe pathophysiology of the metabolic syndrome

A

insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

early major contributor to development of insulin resistance

A

overabundance of circulating fatty acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

most sensitive pathway of insulin action

A

inhibition of lipolysis in adipose tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

pathologic mechanism to explain metabolic syndrome

A

leptin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

provides the unifying theory for aging and the predisposition to the metabolic syndrome

A

oxidative stress hypothesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

recently emerged as an important contributor to the development of obesity and related metabolic disorders

A

??

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

excellent marker of the insulin resistant condition

A

hypertriglyceridemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

other major lipoprotein disturbance in metabolic syndrome

A

reduction in HDL cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

inhibitory to lipoprotein lipase further controbuting to hypertriglyceridemia

A

Increase in apoC-III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

True or false. Hyperuricemia is another consequence of insulin resistance

A

True.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how does uric acid lead to hypertension

A

effect of uric acid on nitric acid synthase in the macula densa of the kidney and stimuation of the renin angiotensin aldosterone system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

proinflammatory cytokines the reflect overproduction by the expanded adipose tissue mass

A

IL 1,6,18; resistin, TNF alpha, CRP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

may be primary source of pro inflammatory cytokines locally and in the systemic circulation

A

adipose tissue macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

anti inflammatory cytokine produced exclusively by adipocytes

A

adiponectin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the action of adiponectin

A

enhances insulin sensitivity and inhibits many steps in the inflammatory process

20
Q

True or false. Reductions in adiponectin levels are common in metabolic syndrome

21
Q

most common liver disease in part as a consequence of the insulin resistance of metabolic syndrome

22
Q

True or false.Women with PCOS are 2-4 times more likely to have metabolic syndrome

23
Q

primary approach to metabolic syndrome

A

weight reduction

24
Q

most important component in weight loss

A

calorie restriction

25
important for the maintenance of weight loss
increase in physical activity
26
reduction of how much leads to weight reduction of 1 lb per week
About 500 kcal restriction daily
27
anti hypertensive of choice for metabolic syndrome
ACEI
28
given to inhibit fat absorption in metabolic syndrome
orlistat
29
given to improve insulin mediated glucose update in muscle and adipose tissue
TZD
30
given to increase HDL cholesterol
nicotinic acid
31
can lead to weight loss but causes headache and nasopharyngitis
lorcaserin
32
side effect of lorcaserin
headache and nasopharyngitis
33
side effect of liraglutide
nausea and emesis
34
appetite suppressants approved by US FDA
phertermine/topiramate, lorcaserin, naltrexone/bupropion and high dose liraglutide
35
dose of liraglutide for weight loss vs in T2DM
3.0 mg liraglutide vs 1.8 mg in T2DM
36
statin dose of those patients with metabolic syndrome with diabetes and known ASCVD
high intensity statin atorvastatin 40-80 mg or rosuvastatin 20-40 mg
37
when should statin therapy by initiated if patient has metabolic syndrome but without diabetes
ASCVD score of 7.5%
38
first drug of choice for lowering LDL
statin
39
second line drug for choice for lowering LDL
ezetimibe
40
what drug may be given in patient with familial hypercholesterolemia with insufficient lowering of LDL on statins and ezetimibe
Proprotein convertase/kexin type 9 (PCSK9 ) inhibitor
41
why are cholestyramine, colestipol and colesevalam which are more effective than ezetimibe in lowering LDL is not given in patients with metabolic syndrome
they can increase triglyceride levels
42
drug of choice to lower triglyceride level
fibrate (gemfibrozil or fenofirate)
43
other drugs that lower triglyceride levels
nicotinic acid and omega 3 fatty acids
44
is the only currently available drug with predictable HDL cholesterol raiding properties
??
45
Physical activity advocated in the management of metabolic syndrome
60-90 min daily activity required
46
when is gastric bypass or vertical sleeve gastrectomy an option
BMI more than 40 with no cormorbities BMI more than 35 with comorbidites