100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached
logo-home
OMA Obesity Medicine Board Review Exam Questions With Correct Detailed Answers. $16.99   Add to cart

Exam (elaborations)

OMA Obesity Medicine Board Review Exam Questions With Correct Detailed Answers.

 8 views  0 purchase
  • Course
  • OMA.
  • Institution
  • OMA.

Ghrelin - correct answer -only known orexigenic gut hormone -inactive form --ghrelin O-acyltransferase (GOAT)--ghrelin-acyl (active form) -Growth Hormone Release Inducing Peptide -secreted by: gastric fundus/body, proximal small intestine (decreased...

[Show more]

Preview 4 out of 65  pages

  • August 8, 2024
  • 65
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • OMA.
  • OMA.
avatar-seller
RealGrades
OMA Obesity Medicine Board Review

Ghrelin - correct answer -only known orexigenic gut hormone

-inactive form --ghrelin O-acyltransferase (GOAT)--ghrelin-acyl (active form)

-Growth Hormone Release Inducing Peptide

-secreted by: gastric fundus/body, proximal small intestine (decreased w/ sleeve gastrectomy--remove
greater curvature of stomach/fundus)

+: empty stomach, weight loss, stress, sleep deprivation, genetics (Prader willi)

-: stomach stretch*^, weight gain, leptin, gastric sleeve--*occurs less in pts w/ obesity, ^inhibited fastest
by CHO, but also rebounds fastes, protein - the longest

-fx: + NPY/AgRP in CNS (arcuate nucleus in hypthalamus) +/- activation of nucleus tractus solitarius
through vagal nerve (vagotomy - ghrelin); + gut motility, - insulin secretion



Ghrelin and weight loss - correct answer -ghrelin levels increase as you lose
weight

-weight regain-->reduced ghrelin levels

-obesity-->reduced decrease in ghrelin post-prandial meals



Small Intestine Hormones - correct answer -short acting, reduce appetite

-goal: cause meal termination

-CCK (cholecystokinin)

-GLP-1 (glucagon-like peptide 1_

-OXM (oxytomodulin)

-PYY (peptide YY)



CCK (Cholecystokinin) - correct answer -released from sm. intestinal I-cells
(duodenum and jejunum)

+: fat/protein ingestion, gastric distension

-short acting (15-30 min)

,-act on rec's in gut and brain:

-CCK-1 rec=GI=slow gastric emptying and + gallbladder contraction

-CCK-2 rec = brain = reduce appetite

-poor pharm studies b/c too short acting and develop tolerance



GLP-1 - correct answer -from L-cells of distal sm. int and colon

+ by: nutrient intake (CHO>protein/fat)

-"incretin" effects: 1) glucose dep't insulin secretion (1st phase insulin response) 2)reduced hepatic
gluconeogenesis (supresses glucagon) 3) delayed gastric emptying (increased satiety) 4) reduced
appetite (weight loss)

-1/2 life = 5min (degraded by DPP-4)



GLP-1 and obesity - correct answer -GLP-1 levels are reduced in: obesity, pre-
DM, T2DM (by enzyme in proximal sm. intestine)

-gastric bypass skips over this inhibitory part of sm. int-->increased GLP-1 levels (why T2DM pts resolve
DM quickly even before they lose weight)



OXM (oxyntomodulin) - correct answer -produced by L-cells of distal small
bowel (co-secreted w/ GLP-1) post-prandially

-works on many rec's-->GLP-1 and glucagon (increases E expenditure)

-fx's: decrease appetite/feeding, increase E expenditure, weight loss

-less GI sx's than GLP-1 (good option for trx)



PYY (Peptide YY) - correct answer -produced b L-cells of distal sm bowel,
colon, rectum

-elevates w/in 1 hr post-feeding

-works on Y2 rec

-fx: potent appetite suppressant/anorexiant, slows gastric emptying and intestinal tract time ("ileal
brake")

-clinical: IV infusion decreased calorie intake x 30% but lots of GI sx's; bariatric surgery -->natural
increase of PYY

,GIP (glucose-dependent insulinotropic polypeptide) - correct answer -
previously gastric-inhibitory peptide

~ GLP-1 (incretin)=together make up 70% postprandial insulin response

-releasted from intestinal K-cells in duodenum and upper jejunum in response to oral glucose load



Large Intestine Hormones - correct answer -same as sm intestine EXCEPT CCK

-GLP-1, OXM, PYY



Pancreatic hormones - correct answer -exocrine (digestion)

-endocrine (glucose homeostatis and reduced feeding):

1. pancreatic polypeptide

2. insulin

3. amylin



Pancreatic Polypeptide (PP) - correct answer -made in F-cells of pancreas in
response to calorie load (~ PYY)

-binds to Y4 rec's:

in gut-->reduced gastric emptying

in hypothalamus--> inhibits NPY mRNA expression-->reduced hunger

-obesity is ass'd with lower PP levels (seen in Prader Willi)



Insulin - correct answer -secreted by pancreatic B-cells in response to feeding

-fx's: glucose homeostasis and fat mgmt (increases nutrient storage peripherally but centrally reduces
appetite)



Insulin's adiposopathy homeostasis fx's - correct answer -1 of 2 long-term
adiposity signaling hormone:

-circulating levels are proportionate to level of body fat

-in hypothalamus it inhibits feeding (AgRP/NPY neurons)

-similar effect to leptin CENTRALLY, but less potent

, -in obesity, insulin resistance attenuates weight-loss effects centrally



Insulin's glucose homeostatis - correct answer Muscle: uptake glucose--
>glycogen; uptake aa's-->protein

Liver: uptake glucose-->glycogen; inhibits fats/protein-->glucose

Adipose: + fat synthesis



Glucagon's glucose homeostasis fx's - correct answer -from alpha cells of
pancreas

-stimulated by low glucose

-inhibited by high glucose, GLP-1, amylin

Liver: +gluconeogenesis (glycogen-->glucose, aa's-->glucose) to keep steady blood sugar through meals



Amylin - correct answer -co-secreted w/ insulin by pancreatic B-cells in
response to meals

-fx's: regulates glucose and bodyweight (1. reduces food intake, 2. slows gastric emptying 3) suppresses
glucagon production/hepatic gluconeogenesis) ~GLP-1 but with less glucose reduction

-makes insulin more effective for glucose lowering

-pharm: pramlintide=amylin analog to reduce insulin need



Pramlintide - correct answer -brand name: Symlin

-amylin analog

-FDA approved for T1DM & T2DM

-administered before meals to reduce insulin req's

-a1c reduction: 0.3-0.6%

-weight loss: 3-4# in 6 mo's (more effective when combined with phentermine--11% TBW loss)



White adipose tissue - correct answer -provides insulation

-helps with mechanical support

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller RealGrades. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for $16.99. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

81113 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy study notes for 14 years now

Start selling
$16.99
  • (0)
  Add to cart