Gastro - Disorders of Appetite Flashcards

(39 cards)

1
Q

What is polydipsia?

A

excessive thirst or excess drinking

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2
Q

What is adipsia?

A

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

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3
Q

What is the clinical definition of anorexia as a symptom?

A

lack or loss of appetite for food

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4
Q

What is obesity?

A

abnormal or excessive fat accumulation that presents a risk to health

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5
Q

What are the 2 different types of polydipsic or adipsic?

A

primary or secondary

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6
Q

What is secondary polydipsia?

A

Medical issues that disrupt any step in osmoregulation or alter ADH

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7
Q

Which type of polydipsia is more common?

A

secondary

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8
Q

What are the 3 main categories of causes of secondary polydipsia?

A

→ chronic medical conditions
→ medications
→ dehydration

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9
Q

What are the chronic medical conditions that causes secondary polydipsia?

A

→ Diabetes insipidus & mellitus
→ Kidney failure
→ Conn’s syndrome
→ Addison’s disease
→ Sickle cell anaemia

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10
Q

What medications can cause secondary polydipsia?

A

→ Diuretics
→ Laxatives
(Both result in dehydration)
→ Antidepressants

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11
Q

What can cause dehydration generally, which can go to cause polydipsia?

A

→ Acute illness
→ Sweating
→ Fevers
→ Vomiting
→ Diarrhoea
→ Underhydration

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12
Q

What are the key differences between diabetes mellitus and diabetes insipidus?

A
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13
Q

What are the common symptoms of diabetes?

A

→ always tired
→ always hungry
→ frequent urination
→ blurry vision
→ numb or tingling hands + feet
→ always thirsty
→ sudden weight loss
→ wounds that won’t heal
→ sexual problems
→ vaginal infections

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14
Q

How does acute kidney failure lead to polydipsia?

A

→ the failing kidneys lose the capacity to concentrate the urine maximally
→ which means that they must excrete more water to eliminate the solutes acquired in the diet
→ As a consequence, patients are forced by thirst to drink more water to cover the loss linked to solute excretion

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15
Q

How does Conn’s syndrome cause polydipsia?

A

v

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16
Q

How does Addison’s disease cause polydipsia?

17
Q

What can cause primary polydipsia?

A

→ Mental illnesses - psychogenic polydipsia
→ Brain injuries
→ Organic brain damage

18
Q

What other mental illnesses can cause primary polydipsia?

A

→ schizophrenia
→ mood disorders (depression + anxiety)
→ anorexia
→ drug use

19
Q

What are the consequences of polydipsia?

A

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

20
Q

What are the different types of polydipsia? What is most common?

A

→ Type A – most common
→ Type B
→ Type C
→ Type D

21
Q

What is the mechanism of adipsia?

A

→ increased osmolality of urine
→ stimulates secretion of ADH
→ water retention
→ sensation of thirst decreases

22
Q

What is an eating disorder?

A

mental illness defined by abnormal eating habits

23
Q

What are some examples of eating disorders?

A

→ Binge eating disorder
→ Anorexia nervosa
→ Bulimia nervosa
→ Pica (eating or craving of things that are not food)
→ Rumination syndrome (rare behavioral disorder in which food is brought back up from the stomach. It is either rechewed, reswallowed, or spit out)
→ Avoidant/restrictive food intake disorder (restricted to eating 1 or 2 types of food, to necessarily to do with body image)

24
Q

What is the prevalence of eating disorders?

A

→ Global eating disorder prevalence increased from 3.4% to 7.8% between 2000 and 2018
→ 70 million people live with eating disorder

25
What are the signs of anorexia?
→ low BMI → continuous weight loss → amenorrhea → halitosis → mood swings → dry hair + skin → hair thinning
26
What are the causes of anorexia?
→ genetics → environmental → psychological → sociological
27
What is the main mechanism of anorexia?
→ something to do with serotonin → mainly unsure
28
What BMI signifies mild anorexia?
BMI \> 17
29
What BMI signifies moderate anorexia?
BMI of 16-16.99
30
What BMI signifies severe anorexia?
BMI of 15-15.99
31
What BMI signifies extreme anorexia?
BMI \< 15
32
Why is obesity increasing?
→ not down to lack of exercise (physical activity started to decline prior to obesity epidemic) → cheap calorie-rich / nutrient poor beverages, sweets + fast food
33
How do you screen for obesity?
→ Height, weight and abdominal girth → Medical history: Dietary and physical activity patterns, psychosocial factors, weight-gaining medications, familial traits → BMI of ≥30 or ≥25 + comorbidity or risk factor
34
What life-style modification is best in treatment of obesity?
→ diet = 8.5% → exercise = 2.4% → diet + exercise = 10.8% therefore both work best
35
When are people referred to surgical treatment of obesity?
people with \> BMI 40 or people with \> BMI 35 and have co-morbidities
36
What are the different surgical treatments for obesity?
→ bariatric surgery = weight-loss surgery → various procedures → most common = Roux-en-Y gastric bypass & sleeve gastrectomy
37
What are the effects of bariatric surgery?
→ WL 5 yrs after BS: 30% - 35% → Remission of comorbidities: → Diabetes (80%) → OSA (80%-85%) → reduction of mortality and morbidity after BS
38
What are the effects of GLP-1 and GLP-2?
→ stimulate insulin release → inhibit glucagon release
39
What are the hormonal changes after BS?
→ reduction of ghrelin → elevation of GLP-1 + GLP-2 + PYY