1.
% of adults that are obese in the US: 30%
2.
% weight loss w/ band (why): 50% (slower wt. loss)
3.
% weight loss w/ gastric bypass + diet + exercise: 60-65%
4.
antrum: 1) G cells
2) delta cells
5.
arterial suppy from left gastric: L gastric->celiac trunk->aorta
6.
benefits of bariatrics (tx of obesity): 1) >80% resolution of type 2 DM & sleep apnea
2) improvement in HTN, Tg, cholesterol
3) decreased mortality (10 yrs=9% bypass, 28% controls)
7.
body (corpus): 1) parietal cells
2) chief cells
8.
cephalic phase of HCl secretion: 1) sight, smell, thought
2) vagal stimulation
9.
chief cells: pepsinogen
-forms proteins->peptides
10.
complications of obesity: 1) surgical
-bleeding
-infx
3) nutritional
-iron def.
-B12
-malabsorption, Ca, vit D
-B1 (rare)
11.
conditions to operate: 1) bleeding
2) perforation
3) obstruction
4) intractability
12.
decreases: 1) life expectancy
2) work productivity
13.
delta cells: somatostatin
-inhibits gastrin release when pH decreases
14.
from gastroduodenal: gastroduodenal->common hepatic->aorta
15.
from L gastroepiploic: L gastroepiploic->splenic->celiac->aorta
16.
from R gastric: R gastric->common hepatic->celiac trunk->aorta
17.
from R gastroepiploic: R gastroepiploic->gastroduodenal->common hepatic->celiac->aorta
18.
from short gastrics: short gastric->splenic->celiac->aorta
19.
function of the stomach: 1) mix & churn food
2) proteolysis
3) osmoregulator
20.
fundus: 1) gastric pacemaker
2) mast cells
21.
G cells: gastrin
-makes gastrin juice when pH increases
22.
gastric phase of HCl secretion: 1) food in stomach
2) stretch receptors
-vagal stimulation
3) chemical receptors
-gastrin secretion
23.
goblet cells: mucus-bicarb rich
24.
HCl stimulates: 1) acetylcholine
2) gastrin
3) histamine
25.
increases: 1) co-morbidites
2) health care costs
26.
inhibition of gastric secretion: secretin (regulates pH) & somatostatin (inhibits gastrin secretion) are released by neg. feedback
27.
intestinal phase of HCl secretion: goes to intestines
28.
mast cells: 1) heparin
2) histamine
3) vasoactive peptides
-wound healing & allergies
29.
most useful measurement of obesity: BMI
30.
nerves of the stomach: 1) parasympathetic
2) vagus
3) LARP
-L=anterior
-R=posterior
31.
NIH consensus statement (1991): bariatric surgery is the most cost effective tx for morbid obesity w/ improvement or resolution of co-morbidites
32.
osmoregulator: maintain homeostasis of the water content of body
33.
parietal cells: 1) HCl
2) intrinsic factor (absorbs B12)
34.
proteolysis: degradation/digestion of proteins
35.
stomach walls (from inner to outer): 1) mucosa
2) submucosa
3) muscularis
4) serosa
36.
type of tx for h pylori: dual or triple therapy
