Obesity and Metabolic Syndrome Pathophysiology

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Questions and Answers

How does increased adipose tissue contribute to insulin resistance in the pathophysiology of obesity?

It reduces the activity of the renin-angiotensin-aldosterone system (RAAS), improving insulin function.
It decreases the production of adipokines, enhancing insulin sensitivity.
It releases excessive amounts of adipokines that inhibit insulin efficacy. (correct)
It directly stimulates glucose uptake by cells, compensating for insulin deficiency.

Which of the following is a direct consequence of adipokines increasing the activity of the renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system?

Vasoconstriction and hypertension (correct)
Hypotension and vasodilation
Decreased VLDL production
Increased HDL levels

How do adipokines affect lipid profiles, specifically regarding VLDL and HDL levels?

They stimulate the liver to increase VLDL production and may break down HDL molecules. (correct)
They decrease VLDL production and increase HDL levels.
They increase both VLDL production and HDL levels.
They have no significant impact on VLDL or HDL levels.

Which of the following conditions must be present for a diagnosis of metabolic syndrome?

At least three out of five key indicators, including hyperglycemia, high blood pressure, and elevated triglycerides. (D) Signup and view all the answers

A patient presents with a fasting blood glucose of 110 mg/dL, blood pressure of 135/90 mmHg, and triglyceride levels of 160 mg/dL. Which additional finding would confirm a diagnosis of metabolic syndrome?

HDL cholesterol of 35 mg/dL in a female patient. (C) Signup and view all the answers

How can hypothyroidism lead to decreased caloric expenditure and contribute to obesity?

By reducing the basal metabolic rate due to low thyroid hormone levels. (C) Signup and view all the answers

How do medications like corticosteroids contribute to increased caloric intake and potential weight gain?

By increasing appetite and promoting overeating. (A) Signup and view all the answers

What is the primary mechanism by which Cushing's syndrome contributes to obesity?

Altered metabolism and fat redistribution. (B) Signup and view all the answers

A patient with a BMI of 38 presents with hypertension, dyslipidemia, and a fasting blood glucose of 130 mg/dL. Which of the following underlying mechanisms is most likely contributing to their elevated blood pressure?

Increased adipokine release stimulating the RAAS and sympathetic nervous system. (C) Signup and view all the answers

A patient with a history of obesity presents with lower extremity claudication during exercise. Which of the following pathophysiological mechanisms most directly links their obesity to their peripheral artery disease?

Adipokine-induced increase in VLDL, decreased HDL, and insulin resistance promoting atherosclerosis. (D) Signup and view all the answers

A patient diagnosed with type 2 diabetes exhibits increased thirst and frequent urination. What is the underlying mechanism directly responsible for these symptoms?

Insulin resistance causing glucose buildup in the bloodstream leading to osmotic diuresis. (C) Signup and view all the answers

A patient with a BMI of 42 reports excessive daytime sleepiness and is suspected of having obstructive sleep apnea (OSA). What is the primary mechanism by which obesity contributes to OSA?

Fat tissue around the neck compressing the upper airway leading to nocturnal hypoxia. (C) Signup and view all the answers

A patient with obesity hypoventilation syndrome (OHS) has elevated daytime PaCO2. How does obesity directly contribute to this condition?

Fat tissue around the chest wall and abdomen impairing lung expansion leading to hypoventilation. (D) Signup and view all the answers

A patient with non-alcoholic fatty liver disease (NAFLD) progresses to non-alcoholic steatohepatitis (NASH). Which of the following mechanisms is most directly responsible for the transition from steatosis to NASH?

Steatosis triggering reactive oxygen species and oxidative stress leading to liver inflammation. (A) Signup and view all the answers

A patient meets criteria for metabolic syndrome. Which combination of findings would support this diagnosis?

Elevated blood pressure, high triglycerides, and low HDL. (B) Signup and view all the answers

A patient is prescribed orlistat for weight management. What is the primary mechanism of action of this medication, and what potential side effect should the patient be counseled about?

Inhibits intestinal lipases; risk of vitamin deficiencies and gastrointestinal symptoms. (C) Signup and view all the answers

A patient with a BMI of 45, type 2 diabetes, and hypertension is considering bariatric surgery. How does Roux-en-Y gastric bypass primarily promote weight loss?

Creating a small stomach pouch and bypassing the duodenum, restricting intake and causing malabsorption. (A) Signup and view all the answers

A patient with a history of depression and obesity is being considered for pharmacological weight management. Which of the following medication combinations would be most appropriate, considering the patient's psychiatric history?

Bupropion/naltrexone (C) Signup and view all the answers

Flashcards

Cause of Obesity

Calorie intake exceeds calorie expenditure.

Lipogenesis

Increased lipid production and storage in adipose tissue.