FMGE 2023 — Physiology

Q: All of the following changes occur in chronic starvation except?

Hyperthermia. ***Hyperthermia*** - Chronic starvation triggers a compensatory decrease in the **Basal Metabolic Rate (BMR)**, which is intended to conserve energy and heat production. - The resulting physiological state is typically **hypothermia** (low body temperature) due to both decreased metabolism and loss of insulating subcutaneous fat, meaning hyperthermia does *not* occur. *Exhaustion* - **Profound exhaustion** occurs due to the catabolism of muscle protein and fat reserves, leading to overall muscle wasting and weakness. - Lack of adequate caloric intake also results in states like **anemia** and **hypoglycemia**, which severely limit physical stamina and mental capacity. *Heart atrophy* - The heart, like skeletal muscle, undergoes **autocannibalism** (breakdown of protein) to supply amino acids for essential organ function. - This reduction in myocardial mass (atrophy) severely compromises **cardiac output** and contributes significantly to clinical instability and potential sudden death. *Hypotension* - **Low blood pressure** results from decreased effective circulating volume and reduced **cardiac output** stemming from bradycardia and myocardial atrophy. - Severe fluid and electrolyte shifts, often coupled with volume depletion, further exacerbate the tendency toward **orthostatic hypotension**.

11 Questions — Page 2 of 2

Q11

All of the following changes occur in chronic starvation except?