NS 1400 Exam 1 Flashcards
(138 cards)
1
Q
what are the 4 characteristics of a disease?
A
- Disease is a condition of the body, its parts, organs, or systems or an alteration thereof
- Results from infection, parasites, nutritional, environmental, genetic, or other causes
- Has a characteristic, identifiable, marked group of signs or symptoms
- Deviates from normal structure or function
2
Q
is obesity a disease?
A
yes, meets essential criteria for disease
3
Q
what is to obesity characterized by?
A
disproportionate body weight for height, owing to an excessive accumulation of adipose tissue
4
Q
what are the two primary cardio-metabolic health risks of obesity?
A
Type II diabetes and hypertension/cardiovascular disease
5
Q
what is metabolic syndrome characterized by?
A
excess of accumulation of fat (outside the adipose tissue) that results in several metabolic disturbances
6
Q
true or false, low triglycerides are associated with metabolic syndrome?
A
false, high triglycerides are a result of the excess accumulation of fat during metabolic syndrome
7
Q
what are the two direct measurements of body composition?
A
- densitometry
- dual X-ray absorptiometry
8
Q
what is the advantage of dual X-ray absorptiometry compared to other composition measurements?
A
it can discriminate across more body compartments including fat, lean mass, and bone
9
Q
true or false, direct measurements of total body fat are affordable and easily accessible?
A
false, challenging, and expensive
10
Q
what is a more feasible alternative to direct composition measurement?
A
anthropometry
11
Q
what are the three anthropometric measurements commonly used for body composition?
A
- BMI
- anatomical fat deposition
- waist to hip ratio
12
Q
what does BMI measure?
A
relative measure of total body weight to height
13
Q
true or false, BMI is clinically feasible?
A
true, shown to moderately correlate with directly measurements of body fat
14
Q
what is the equation for BMI in both kg/m and lb/in?
A
BMI = weight (kg)/height (m)^2
BMI = weight (lbs) / height (in)^2 x 703
15
Q
what BMI is considered obese?
A
> = 30
16
Q
does BMI account for the impact of lean muscle mass to total body weight?
A
No
17
Q
does BMI account for body fat distribution?
A
no
18
Q
true or false, measurements of waist-to-hip ratio are a better predictor of cardiovascular disease and events than BMI
A
true
19
Q
what are the two types of adipose tissue distribution?
A
subcutaneous adipose tissue &
visceral adipose tissue
20
Q
which type of adipose tissue is more concerning towards obesity related health risk?
A
visceral accumulation of fat
21
Q
where does visceral tissue surround?
A
internal organs
22
Q
where does subcutaneous tissue lie?
A
under the dermis of the skin
23
Q
what percentage of total body fat does subcutaneous adipose tissue make up?
A
> 80%
24
Q
what are the two types of fat distribution?
A
android and gynoid
25
what is excess central adiposity called?
android obeisty
26
what shape is android obesity associated with?
apple shape
27
what shape is gynoid obesity associated with?
pear shape
28
what is associated with a greater risk of health complications, gynoid or android obesity?
android
29
android obesity is associated with higher/lower intra-abdominal AT and higher/lower subcutaneous AT?
higher, lower
30
what basically causes excessive fat deposition?
deviations of energy balance, when amount of energy consumed (calories) is greater than the amount of energy the body expends/requires
31
describe the negative feedback loop of body weight regulation?
senses positive/negative fluctuating in energy balance either nutrient or hormone related. initiates counter response to set off the deviation in energy balance (food intake or alteration in metabolism)
32
what is the role of the hypothalamus?
to receive chemical signals (hormones) and to coordinate a response to those signals
33
what is the primary site for integrating endocrine signals in the hypothalamus?
arcuate nucleus
34
what are the two types of ARC neurons that regulate food intake and energy balance?
orexigenic neurons and anorexigenic neurons
35
what do orexigenic neurons do?
stimulate appetite in the fasted state
36
what do anorexigenic neurons do?
suppress appetite in the fed state
37
what are the two types of orexigenic neurons?
agouti-related peptide (AgRP)
neuropeptide Y (NPY)
38
what are the two types of anorexigenic neurons?
pro-opiomelanocortin (POMC)
a-MSH
39
neural circuits are regulated by the peripheral cues from where?
gut, pancreas, and fat
40
what hormone is produced in adipose tissue?
leptin
41
what is leptin levels proportional too?
fat stores
42
what neurons does leptin activate and what neurons does it inhibit?
directly activates POMC expression and inhibits AgRP/NPY expression
43
what is the net effect of leptin of food intake and energy expenditure?
inhibits food intake and increases energy expenditure
44
what hormone is secreted in the beta cells of the pancreas?
insulin
45
what does insulin do to neurons?
activates insulin receptors on POMC and AgRP/NPY neurons that change neuronal sensitivty
46
what is the function of insulin?
insulin potentates the satiety action of leptin
47
true or false, gut hormones are short term regulators which have both orexigenic and anorexigenic effects that fluctuate between meals?
true
48
what gut hormone stimulates food intake?
ghrelin
49
what are the three gut hormones that inhibit food intake?
1. glucagon like peptide (GLP-1)
2. Peptide YY 3-36 (PYY)
3. Cholecystokinin (CCK)
50
true or false, most microbes in the body exist in a symbiotic way?
true
51
what are three ways that microbiota can benefit health?
1. detoxify compounds
2. synthesize vitamins
3. digest indigestible foods
52
what can microbiota produce that acts as an additional nutrient source and prevents chronic disease?
short chain fatty acids
53
Total energy expenditure (TEE) is the sum of what three components?
1. resting energy expenditure
2. thermal effect of food
3. activity-related energy expenditure
54
what is resting metabolic rate?
energy requirements of the body to maintain vital functions when at rest
55
what refers to heat production in response to environmental changes?
adaptive thermogenesis
56
what is post-prandial thermogenesis?
energy needed to metabolize meals
57
what foods have the highest Thermic effect of food (TEF)
proteins, fats have the lowest
58
true or false, energy spent in physical activity makes the largest contribution towards TEE?
false, second most but it is the most modifiable component
59
what types of tissue is adipose tissue?
connective support tissue
60
what type of adipose tissue is responsible for energy reservoirs?
White adipose tissue (WAT)
61
what two types of adipose tissue are responsible for thermogenic centers?
brown adipose tissue (BAT) and
beige adipose tissue
62
what is the most abundant type of adipose tissue?
White adipose tissue
63
what are three histological features of WAT?
small cytoplasm, flattened, non-centrally located nuclei, large fat droplets
64
when energy is abundant what do white adipocytes do?
store excess E in the form of triacylglycerol
65
when energy is scare what do white adipocytes do?
break down triacylglycerols to FFA and glycerol to generate ATP
66
what are three histological features of brown adipocytes?
fat droplets of varying sizes, central nuclei, large cytoplasm, numerous mitochondira
67
what is the least abundant adipocyte?
brown adipose tissue
68
why are brown adipocytes important for thermogenesis?
rich in uncouple protein 1 and broken down fatty acids generated by BAT are used to generate heat
69
what do BAT generate their color from?
high vascularization and high presence of mitochondria
70
what does aging do to beige adipocytes?
reduces depots of beige adipose tissue
71
what does obesity do to adipose tissue?
expands it
72
what is hypertrophy?
increase in cell size
73
what is hyperplasia?
increase in cell number
74
is hyperplasia good or bad?
good, protective
75
is hypertrophy good or bad?
bad, damaging
76
what does expansion of adipose tissue cause?
enlarges adipocytes which impede circulation and promotes hypoxia
77
what does hypoxia cause?
low oxygen triggers release of pro-inflammatory cytokines and migration of immune cells
78
what happens if hypoxia is not released?
adipocytes undergo cell death and excess extracellular matrix proteins accumulate causing scar tissue buildup. This causes loss of normal function
79
what are adipokines?
proteins or hormones that regulate a variety of physiological functions
80
when are adipokines produced?
in response to anatomical and physiological changes in adipose tissue
81
what type of adipokines does dysfunctional adipose tissue produce?
pro-inflammatory adipokines
82
what are the two main effects of pro-inflammatory adipokines?
insulin resistance and atherogenesis (vascular remodeling: stroke, myocardial infarction, peripheral artery disease)
83
why is visceral fat the only type that causes increased risk of metabolic syndrome?
visceral fat has PRO-inflammatory adipokines and also reduced anti-inflammatory adipokines
84
what is ectopic fat deposition?
accumulation of triglycerides in non-adipose tissue
85
what happens to hypertrophied adipocytes?
become saturated and cannot store additional fat
86
how does hyperplasia help against harmful ectopic fat?
acts as a metabolic sink that prevents lean tissue against fat
87
what does ectopic fat lead to?
local cell dysfunction, impaired metabolism, cell death (lipotoxicity)
88
true of false, body weight is highly heritable evidenced by the fact that monozygotic twins have more concordant body weight than that of dizygotic twins?
true
89
what is a gene?
basic physical and functional unit of hereditary, composed of DNA, that can act as a set of instructions to make proteins
90
what are small differences in the same gene called?
alleles
91
what is characteristic of monogenic obesity?
single mutation in one gene
92
is monogenic early-onset or delayed onset?
early-onset
93
is monogenic obesity severe or normal?
severe
94
what are some common behaviors of monogenic obesity?
constant hunger, lack of satiety, food seeking behavior, increased food consumption
95
what is polygenic obesity?
hundred of variants in or near many genes
96
how to identify polygenic obesity?
screening the entire genome in large sample study, identify single nucleotide polymorphism associated with BMI and other obesity traits
97
what are the genome wide association studies?
identified >300 genetic loci that confer obesity susceptibility
98
is polygenic obesity severe or common?
common
99
what is the name of the 5 stage system of obesity classification that considers metabolic, physical, and physiological parameters to determine optimal obesity treatment
Edmonton Obesity Staging System
100
what are the 4 parameters of the system?
- signs of obesity related risk factors
- physical symptoms
- physiological symptoms
- functional limitations
101
what are the three classes of WHO's obesity scale based on BMI?
obese class 1 = 30-35
obese class II = 35-40
obese class III = >40
102
in general what are stage 0 and stage 1 patients parameters?
either NO or MILD risk factors, symptoms and limitations
103
what is the treatment for stage 0 & 1?
lifestyle intervention, counseling, monitoring health risks
104
in general what are stage 2 patients parameters?
pronounced risk factors requiring care, moderation functional limitations or moderate psychological symptoms
105
what is the treatment for stage II?
lifestyle intervention, counseling, consideration of behavioral, drug, and surgical options
106
in general what are the parameters of stage 3 and 4 patients?
significant end organ damage, severe or grave functional limitations and physiological symptoms
107
what is the treatment for stage 3 and 4?
implementation of drug and surgical interventions
108
what are the three lifestyle interventions?
first-line therapy, drug therapy, bariatric surgery
109
what are the three components of first line therapy?
1. meal plan
2. physical activity
3. behavior
110
is drug therapy best implemented alone or in combination?
combination therapy has an additive effect on weight loss and metabolic risks
111
true or false, bariatric surgery is highly effective and reduces long term obesity related mortality?
true
112
what are the 4 types of bariatric surgery?
1. gastric sleve
2. RNY gastic bypass
3. Gastric banding
4. duodenal switch
113
which of the 4 types of bariatric surgery are reversible?
gastric banding
114
why is weight by age more effective for children?
body composition in children varies with age and gender so BMI needs to be expressed relative to other children of the same age and sex
115
how was the patient treated?
recombinant leptin administration
116
what were the results?
rapid onset reductions in body weight within 2 weeks, sustained over 12 month period
117
why did leptin result in weight loss?
exogenous leptin treatment introduces the missing satiety factor.
118
who discovered leptin?
Jeffery M. Friedman
119
can leptin administration result in weight loss for individuals without deficiency?
no, common obesity is associated with increased serum leptin. Become insensitive to leptin suggesting a defect in LEPR signaling
120
how does leptin induce satiety?
LEP directly activated LEPR on POMC neurons to promote aMSH which acts on MC4R to induce satiety
121
how do you define health?
the ability to adapt and to self manage in pursuit of physical, mental and social well-being
122
what are the three subclasses of the biological determinants of health?
1. innate
2. structural
3. functional
123
what branch of biology studies the innate determinant?
genetics
124
what branch of study covers the structural determinant?
anatomy
125
what branch of study covers the functional determinant?
physiology
126
what are the 4 types of genetic determinants?
1. single gene
2. chromosomal
3. multifactorial
4. mitochondrial DNA linked
127
what are the 4 classifications of diseases?
congenital vs acquired
acute vs chronic
128
what are the two categories of acquired disease?
communicable & non-communicable
129
what are communicable acquired diseases?
includes contagious and non-infectious diseases
130
what are non-communicable diseases?
includes non-infectious diseases that develop slowly and persist from several weeks to years
131
what are acute disease?
suddenly appear and last short time
132
what are chronic diseases?
slow development and is long lasting
133
what are the three main causes of health disparity?
1. poverty
2. social injsutice
3. culture
134
what is the premise of economics?
allocation of scare resources among competing ends
135
what is opportunity cost?
forgone benefit that would have been derived by an option not chosen
136
advantages of using BMI?
easy to do, non-invasive, inexpensive, can be readily understood
137
criticism of BMI?
almost all work done on male caucasians, does not distinguish between muscle mass and fat, correlation between % body fat and BMI is not perfect, more accurate ways
138
why is there an upward trend in obesity? two views?
1. obesogenic environment (enables weight gain and restricts weight loss)
2. changes in individual behavior
