Prefinal OSCE

1. How does visceral fat lead to chronic kidney disease ?

Increased visceral fat accumulation causes adipose tissue inflammation and adipokine dysregulation , which can lead to dyslipidemia, insulin resistance, renin-angiotensin-aldosterone system (RAAS) overactivation , sodium retention ,extracellular fluid volume expansion.

Increased visceral fat accumulation is also accompanied with perirenal and renal sinus fat accumulation, which causes high intrarenal pressure, which leads to compression of the vasa recta capillaries and thin loops of Henle, reduced blood flow in the renal medulla, increased sodium reabsorption in the loop of Henle, RAAS activation, and increased sodium reabsorption

These pathological conditions interact in a complex manner, ultimately damaging the kidneys by causing glomerular hyperfiltration and inflammation both of which are characteristics of obesity-related kidney disease

Reference - https://www.frontiersin.org/articles/10.3389/fendo.2023.1097596/full#:~:text=Increased%20visceral%20fat%20accumulation%20causes,%2C%2040)%2C%20sympathetic%20nervous%20system

2. How are carbohydrates converted into fats?

Glucose —> pyruvate —->Acetyl coA —-> citrate —-> Malonyl - coA —-> Palmitate —-> Fatty acids 

(Glycolysis & lipogenesis )

The incidence of metabolic syndrome, a condition characterized by the constellation of central obesity, dyslipidemia, hepatic steatosis, elevated blood glucose, and hypertension. Increased de novosynthesis and secretion of lipids from the liver contributes significantly to the hepatic steatosis and dyslipidemia associated with type 2 diabetes. Hepatic lipogenesis is activated after ingestion of high-carbohydrate, low-fat diet to generate fat from dietary carbohydrate. Insulin plays a critical role in this process by activating a well-characterized lipogenic transcription factor, SREBP-1c. In the insulin-resistant state, elevated circulating insulin further stimulates fatty acid synthesis and very low density lipoprotein (VLDL) secretion. 

Reference - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096021/

Comments

Post a Comment

Popular posts from this blog

55 yr old male with CKD 2° to DM

Image
  This is online E log book to discuss our patient’s de-identified health data shared after taking his/her/guardian’s signed informed consent. Here we discuss our individual patient’s problems through series of inputs from available global online community of experts with an aim to solve those patients’ clinical problems with collective current best evidence-based inputs.  This e-log book also reflects my patient centred online learning and your valuable inputs on comment box is welcome. I’ve been given this case to solve in an attempt to understand the topic of “patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations, and come up with diagnosis and treatment plan. A 55 yr old male from suryapet  came with chief complaints of generalized body swelling since 15 days,shortness of breath since 15 days, decreased urine output since 10 days. History of presenting illness: Patient was appare
Read more

General Medicine assignment

    General medicine monthly online summative assesment Likitha Godavarthi roll no: 69 General medicine assignment(3rd sem)   QUESTION-1 1. CARDIOLOGY REVIEW: https://dthanmai27.blogspot.com/ CASE: https://preityarlagadda.blogspot.com/2021/05/biatrial-thrombus-in-52yr-old-male.html This is a case of atrial fibrillation and biatrial thrombosis. patent is a known patient of hypertension which might have let to the formation of thrombus. due to the formation of thrombus cardiac output was low leading to decreased GFR leading to the increased action of renin and aldosterone . increased aldosterone leads to sodium retention . this explains the puffiness of her face .dytor was recommended as it has antagonistic actions against aldosterone. 2.NEUROLOGY REVIEW: https://dthanmai27.blogspot.com/2021/05/online-blended-bimonthly-assignment.html   CASE: https://kausalyavarma.blogspot.com/2021/05/a-52-year-old-male-with-cerebellar.html?m=1 This is a case of cerebellar ataxia. patient has hypertensio
Read more