Final: Metabolic syndrome

Question 1

metabolic syndrome PE

Answer 1

• screen for CV complications
• acanthosis nigricans (diffuse hyperpig velvety thick skin on neck and axillae) + skin tags
• obesity
• BMI & waist to hip ratio correlates with insulin resistance (high reliability)

Question 2

metabolic syndrome diagnosis adults

Answer 2

need 3 out of 5:

• Waist
  
  • male: > 40 inches
  • women: > 35 inches
• Triglyceride >150 +
• Reduced HDL cholesterol
  
  • < 40 males
  • < 50 in females,
• SBP > 130/> 85
• Fasting glucose >100

Question 3

metabolic syndrome in children (age 10-16)

Answer 3

• same as adults
• except waist > 90% for age, gender, race

Question 4

metabolic syndrome is characterized as

Answer 4

• cluster of disorders
• insulin resistance with hyperinsulinemia
• hypertension
• abdominal (central or visceral) obesity
• dyslipidemia, hypertriglyceridemia
• LDL cholesterol
• added recently: C-Reactive protein (CRP) levels, increased plasminogen activator and microalbuminemia

Question 5

metabolic syndrome should be screened

Answer 5

yearly for

hyperglycemia, glucose intolerance and DM 2

Question 6

intial diagnostics for metabolic syndrome

Answer 6

• A1c
• BMP
• fasting lipid profile
• C-reactive protein
• Liver panel
• TSH
• uric acid

Question 7

very high triglyceride levels (200+) can provoke

Answer 7

acute episode of pancreatitis! get doc consultation on HTN/dyslipidemia if resistant to therapy

Question 8

metabolic syndrome management / goals

Answer 8

• 150 mins mod exercise per week to get 7% weight loss
• BP goal: < 130/85 (ACE/ARB, CCB, BB)
• triglycerides < 150, LDL < 100, HDL >40 men, > 50 women
  
  • statins
  • ezetimibe
  • if triglycerides >500 = give gemfibrozil, fenofibrate or niacin
  • monitor creatine kinase (CK) when on statin
• aspirin as prophylaxis for CVD
• metformin
• Pioglitazone (Thiazolidinediones)

weight reduction! rec 10% decrease w/in 6 months