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3D week 2 - Hormones > obesity and cardiometabolic risk > Flashcards

obesity and cardiometabolic risk Flashcards

1
Q

what 2 hormones have key roles in obesity

A

leptin and ghrelin

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2
Q

what is leptin

A

a hormone released by adipose tissue that regulates hunger by stimulating satiety

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3
Q

what is ghrelin

A

a multifaceted hormone that stimulates the hunger sensation and thus the drive to eat

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4
Q

6 adverse cardiometabolic effects of products of adipocytes

A
  1. hypertension (↑ angiotensinogen)
  2. atherogenic dyslipidaemia
  3. type 2 diabetes
  4. thrombosis
  5. atherosclerosis
  6. inflammation (↑ TNFa, ↑IL6 etc.)
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5
Q

how may obesity impact mental health

A

ma trigger depression, EDs, distorted body image and low self esteem; stigma around being obese may also contribute to the development of these conditions

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6
Q

why might the parent’s opinions causes childhood obesity to persist

A

many parents don’t recognise obese children =>no motivation for children to lose weight

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7
Q

what is metabolic syndrome

A

a group of health problems that put you at risk of type 2 diabetes or conditions that affect your heart or blood vessels

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8
Q

4 characteristics of metabolic syndrome

A
  1. insulin resistance
  2. hyperlipidemia
  3. autonomic dysfunction
  4. raised BP
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9
Q

metabolic syndrome diagnostic criteria

A

central obesity (BMI > 20 or high waist circumfrence) + and 2 of:
- high triglyceride (>1.7mmol/L on statin)
- reduced HDL
- raised BP (>130/85)
- raised fasting plasma glucose (5.6mmol/L or diagnoses T2DM)

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10
Q

what is blount’s disease

A

a growth disorder that affects the bones of the lower leg, causing them to bow outward -> excess weight on growth plates

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11
Q

what are the main resp obesity complications (3)

A
  1. hypoventilation
  2. Obtructive sleep apnoea
  3. central apnoea
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12
Q

what are the main derm obesity complications (2)

A
  1. hirsutism
  2. sweating
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13
Q

what are the main hepato-billary obesity complications (3)

A
  1. gall stones
  2. non alcoholic fatty liver
  3. colon cancer
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14
Q

what are the main endocrine obesity complications (3)

A
  1. sex hormone disorders
  2. pituitary hormone abnormalities
  3. impaired immunity
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15
Q

what are the main cardio obesity complications (3)

A
  1. hypertension
  2. ischaemic heart disease
  3. thromboembolism
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16
Q

what are the main reproductive obesity complications (3)

A
  1. hypogonadism
  2. infertility
  3. menorrhagia
17
Q

what are the main ortho obesity complications (2)

A
  1. OA
  2. gout
18
Q

how does obestiry lead to heart failure (pathway)

A

obesity -> expansion of intravascular volume -> increase cadiopulmonary volume/preload -> eccentric left ventricular hypertrophy -> ventricular dysarrythmias and systolic/diastolic heart failure

19
Q

which cancers are at highest risk of developing due to obesity (8)

A
  1. endometrial
  2. oesophageal
  3. pancreatic
  4. kidney
  5. breast (post menopausal)
  6. colorectal
  7. ovarian
  8. gall bladder
20
Q

what is key to find out in an obesity history

A

cause for weight gain -> is this treatable

21
Q

what is overweight bmi

A

> 25 is overweight, obese is >30

22
Q

what is acanthosis nicgrans

A

areas of dark, thick velvety skin in body folds and creases -> associated with insulin resistance -> often seen in obesity

23
Q

what 3 visual findings are associated with insulin resistance

A
  1. acanthosis nicgrans
  2. skin tags
  3. lipoedema
24
Q

obesity mgx

A

non surgical:
1. lifestyle changes (regular exercise, healthy eating, alcohol recommendations and smoking cessation etc.)
2. drug treatment (onlyif not responsive to lifestlye change) - orlistat and liraglutide

surgical:
bariatric surgery e.g. Roux-en-Y gastric bypass, sleeve gastrectomy, and gastric bypass

25
Q

5 As of obesity counselling

A
  1. Assess: identify patient at risk
  2. Ask: “Before you leave could I check your weight today?”
  3. Advise: “One of the best ways to lose weight is with support and {insert name of weight management service} is available today. I can refer you now if you are willing to give it a go?”
  4. Assist in establishing interventions and securing goal attainment
  5. Actions: Make the referral, document the conversation, follow up with the patient
26
Q

orlistat MOA

A

preventing the absorption of dietary fat -> side effects of flatulence and loos stools

27
Q

liraglutide MOA

A

glucagon-like peptide-1 (GLP-1) analogue and a diabetic drug used to treat weight loss. It works by delaying gastric emptying and inducing early satiety resulting in an overall reduction in calorie intake and weight loss

28
Q

what is the most cost effective obesity management combination

A

surgery + lifestyle change -> but surgery is not available everywhere

29
Q
A

3D week 2 - Hormones (8 decks)

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