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Year 3 Reproductive and Endocrinology Random Conditions > Metabolic Syndrome > Flashcards

Metabolic Syndrome Flashcards

1
Q

Which key hormone is responsible for modulating metabolism?

1 - insulin
2 - cortisol
3 - thyroxine
4 - mineralcorticoids

A

3 - thyroxine

  • high thyroxine = weight loss
  • low thyroxine = weight gain
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2
Q

Does glucocorticoids, specifically cortisol typically lead to weight gain or weight loss?

A
  • weight gain
  • like in Cushing syndrome
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3
Q

The are three parts of the hypothalamus that regulate food intake:

  • ventromedial nuclei
  • lateral hypothalamic area
  • arcuate nucleus

Which of these is called the satiety (fullness) centre?

A
  • ventromedial nuclei
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4
Q

The are three parts of the hypothalamus that regulate food intake:

  • ventromedial nuclei
  • lateral hypothalamic area
  • arcuate nucleus

Which of these is called the feeding (hunger) centre?

A
  • lateral hypothalamic area
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5
Q

The are three parts of the hypothalamus that regulate food intake:

  • ventromedial nuclei
  • lateral hypothalamic area
  • arcuate nucleus

What is the function of the arcuate nucleus?

1 - amplifies lateral hypothalamic area
2 - amplifies ventromedial nuclei
3 - inhibits ventromedial nuclei
4 - regulates both the ventromedial nuclei and lateral hypothalamic area

A

4 - regulates both the ventromedial nuclei and lateral hypothalamic area

  • receives signals from the GIT
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6
Q

Hunger is stimulates when the stomach is empty. Mechanoreceptors in the stomach and recognise the stomach is empty. Which 2 of the following then occurs to stimulate hunger?

1 - mechanoreceptors stimulate vagus nerve
2 - mechanoreceptors directly stimulate the lateral hypothalamic area
3 - mechanoreceptors signal the release of ghrelin from PD-1 cells in stomach
4 - all of the above

A

1 - mechanoreceptors stimulate vagus nerve (VN)
- VN stimulates solitary nucleus (SN) in medulla
- SN stimulates arcuate nucleus that stimulates the lateral hypothalamic area

3 - mechanoreceptors signal the release of ghrelin from
- stimulates the lateral hypothalamic area via the arcuate nucleus

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7
Q

In addition to mechanoreceptors signalling hunger, levels of what in the blood also signals hunger. Levels of what in the blood signal hunger?

1 - insulin
2 - HDL
3 - glucose
4 - glucagon

A

3 - glucose

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8
Q

Fullness (satiety) is stimulated when the stomach is stretched and mechanoreceptors in the stomach fire. What then happens?

1 - mechanoreceptors stimulate vagus nerve
2 - mechanoreceptors directly stimulate the lateral hypothalamic area
3 - mechanoreceptors signal the release of ghrelin from PD-1 cells in stomach
4 - all of the above

A

1 - mechanoreceptors stimulate vagus nerve (VN)
- VN stimulates solitary nucleus (SN) in medulla
- SN stimulates arcuate nucleus that stimulates the ventromedial nuclei area

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9
Q

In addition to mechanoreceptors that signal fullness via the vagus nerve, there are chemoreceptors that are able to detect macronutrients. When lipids and amino acids are digested and detected by chemoreceptors, what is released from I cells in the small intestines?

1 - leptin
2 - GLP-1
3 - secretin
4 - cholecystokinin

A

4 - cholecystokinin

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10
Q

During fullness L cells in the ileum and colon secrete what?

1 - peptide YY
2 - GLP-1
3 - secretin
4 - cholecystokinin

A

1 - peptide YY

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11
Q

During fullness L cells in the ileum and colon secrete peptide YY. In addition, low levels of glucose in the blood can also stimulate L cells to secrete incretins. What is the name of this second peptide hormone secreted from L cells?

1 - leptin
2 - glucagon like peptide-1 (GLP-1)
3 - secretin
4 - cholecystokinin

A

2 - glucagon like peptide-1 (GLP-1)

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12
Q

There is a second incretin that is released into the GIT in response to eating, what is this called?

1 - peptide YY
2 - secretin
3 - cholecystokinin
4 - Glucose-dependent insulinotropic peptide (GIP)

A

4 - Glucose-dependent insulinotropic peptide (GIP)

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13
Q

Glucose-dependent insulinotropic peptide (GIP) and glucagon like peptide-1 (GLP-1) are both incretins. Does the incretin effect increase or decrease insulin release from the pancreas?

A
  • increase insulin release
  • more insulin release when glucose is taken in orally vs when given via IV
  • indicates incretins (GLP-1 and GIP) in GIT have a big effect on insulin release
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14
Q

Of the following, which hormone does NOT stimulate the arcuate nucleus, which subsequently stimulates the - ventromedial nuclei?

1 - peptide YY
2 - glucagon like peptide-1 (GLP-1)
3 - secretin
4 - cholecystokinin

A

3 - secretin

  • all other signal fullness
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15
Q

In addition to contributing to the sensation of fullness, what is the 2nd function of peptide YY?

1 - stimulates bile release
2 - stimulates pancreas to increase insulin release
3 - inhibit ghrelin release
4 - inhibits insulin release from pancreas

A

3 - inhibit ghrelin release
- also inhibits gastric motility
- means mechanoreceptors are stretched and therefore we feel fuller for longer

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16
Q

In addition to contributing to the sensation of fullness, what is the 2nd function of peptide glucagon like peptide-1 (GLP-1)?

1 - stimulates bile release
2 - stimulates pancreas to increase insulin release
3 - inhibit ghrelin release
4 - inhibits insulin release from pancreas

A

2 - stimulates pancreas to increase insulin release

  • Glucose-dependent insulinotropic peptide (GIP) also does this
  • incretins GLP-1 and GIP also inhibit glucagon release from the pancreas
17
Q

Which 2 of the following drugs can be used to increase the efficacy of incretins such as glucose-dependent insulinotropic peptide (GIP) and glucagon like peptide-1 (GLP-1) by inhibiting the enzyme DPP-4, an enzyme which destroys the hormone incretin?

1 - Gliclazide
2 - Metformin
3 - Linagliptin
4 - Sitagliptin

A

3 - Linagliptin
4 - Sitagliptin

  • more incretins means better stimulation of insulin response from pancreas
18
Q

In addition to contributing to the sensation of fullness, what is the 2nd function of cholecystokinin?

1 - stimulates bile release and increases gut motility
2 - stimulates pancreas to increase insulin release
3 - inhibit ghrelin release
4 - inhibits insulin release from pancreas

A

1 - stimulates bile release and increases gut motility

19
Q

Does insulin stimulate satiety (fullness) or hunger?

A
  • satiety (fullness)
  • stimulates hypothalamus directly
20
Q

All of the following are acute satiety (fullness) hormones, because the fluctuate throughout the day in response to food and exercise, EXCEPT which one?

1 - peptide YY
2 - leptin
3 - glucagon like peptide-1 (GLP-1)
4 - insulin
5 - cholecystokinin

A

2 - leptin
- considered the long term satiety hormone and stimulates the hypothalamus

  • insulin sometimes thought of as a long term as well
21
Q

Do leptin levels change throughout the day?

A
  • increase at night
  • reason we are not hungry when sleeping
22
Q

Which cells do the majority of leptin get produced by?

1 - skeletal muscle
2 - mammary glands
3 - placenta
4 - white adipose

A

4 - white adipose

23
Q

Which gene encodes leptin?

1 - HMG-CoA
2 - ob gene
3 - MC4R
4 - LEPR

A

2 - ob gene
- mice with missing ob gene become obese

24
Q

Would a lean or obese individual have higher leptin levels?

A
  • obese
  • idea is that if we have more fat this tell the body not to eat more
25
Q

Do orexigenic hormones relate to hunger or satiety (fullness)?

A
  • hunger
26
Q

Do anorexigenic hormones relate to hunger or satiety (fullness)?

A
  • satiety (fullness)?
27
Q

If we have a high ghrelin and a low leptin, are we more likely to be in a catabolic (break down) or anabolic (building) state?

A
  • anabolic (building)
  • hold onto what we have and store it
  • likely to increase food intake and gain weight
28
Q

If we have a low ghrelin and a high leptin, are we more likely to be in a catabolic (break down) or anabolic (building) state?

A
  • catabolic (break down)
  • we have fat to burn for energy
29
Q

In genetic aetiology of obesity, which of the following match the following definition?

  • a single gene mutation, primarily located in the leptin-melanocortin pathway

1 - Monogenic causes
2 - Syndromic obesity
3 - Polygenic obesity

A

1 - Monogenic causes

  • leptin pathway is the most well known
30
Q

In genetic aetiology of obesity, which of the following match the following definition?

  • severe obesity associated with other phenotypes such as neurodevelopmental abnormalities

1 - Monogenic causes
2 - Polygenic obesity
3 - Syndromic obesity

A

3 - Syndromic obesity

31
Q

In genetic aetiology of obesity, which of the following match the following definition?

  • cumulative contribution of a large number of genes whose effect is amplified in a ‘weight gain promoting’ environment

1 - Monogenic causes
2 - Polygenic obesity
3 - Syndromic obesity

A

2 - Polygenic obesity
- majority of obesity cohort
- genes and environmental factors

32
Q

All of the following signs belong to which syndromic obesity genotype?

  • retinal dystrophy
  • obesity
  • post-axial polydactyly
  • renal dysfunction
  • learning difficulties
  • hypogonadism

1 - Down syndrome
2 - Bardet-Biedel Syndrome (BBS)
3 - 16p11.2 microdeletion syndrome
4 - Prader Willi Syndrome (PWS)

A

2 - Bardet-Biedel Syndrome (BBS)
- autosomal recessive condition

33
Q

Which of the following is the most common form of syndromic obesity?

1 - Down syndrome
2 - Bardet-Biedel Syndrome (BBS)
3 - 16p11.2 microdeletion syndrome
4 - Prader Willi Syndrome (PWS)

A

4 - Prader Willi Syndrome (PWS)
- incidence of 1 in 15,000–25,000 births

34
Q

Absence of expression of paternal genes from chromosome 15q11.2-q13 leads to multi‐system involvement causing:

  • severe hypotonia
  • poor suck and feeding difficulties in early infancy
  • short stature is common
  • morbid obesity

These are all common in which form of syndromic obesity?

1 - Down syndrome
2 - Bardet-Biedel Syndrome (BBS)
3 - 16p11.2 microdeletion syndrome
4 - Prader Willi Syndrome (PWS)

A

4 - Prader Willi Syndrome (PWS)

  • caused by missing paternal genes
35
Q

Heterozygous deletion of ~593-kb region on chromosome 16 leads to the following:

  • developmental delay
  • intellectual disability
  • autism spectrum disorder
  • severe obesity

These are all common in which form of syndromic obesity?

1 - Down syndrome
2 - Bardet-Biedel Syndrome (BBS)
3 - 16p11.2 microdeletion syndrome
4 - Prader Willi Syndrome (PWS)

A

3 - 16p11.2 microdeletion syndrome

36
Q

What is the typical BMI cut off for bariatric surgery?

1 - >30
2 - >35
3 - between 35-40
4 - >40

A

4 - >40

37
Q

The typical BMI cut off for bariatric surgery is >40. However, which of the following can this be altered in?

1 - BMI between 35 and 39.9 and a severe obesity‐related comorbidity such as diabetes and hypertension
2 - BMI between 30 and 34.9 and poorly controlled diabetes
3 - Asian descent
4 - all of the above

A

4 - all of the above

  • asians are at increased risk of diabetes and other comorbidities

Year 3 Reproductive and Endocrinology Random Conditions (5 decks)

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