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Apex Review > Obesity > Flashcards

Obesity Flashcards

1
Q

How many calories are required to produce one gram of body fat?
a. 4
b. 7
c. 9
d. 11

A

c. 9

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2
Q

According to the National Institute of health, ______ ranks second to smoking as the leading cause of preventable death.

A

adult obesity

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3
Q

Childhood obesity is more common than

A

diabetes
cystic fibrosis
& all cancers

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4
Q

Each gram of carbohydrate and protein provides __ calories of physiologically available energy

A

4

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5
Q

The etiology of obesity is multifactorial and influenced by

A

social
pharmacologic
pathophysiologic
genetic factors

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6
Q

Social causes of obesity include

A

overeating
poor access to proper nutrition

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7
Q

Obesity as a result of medication side effects can be from

A

steroids
antidepressants

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8
Q

Diseases that can lead to obesity include

A

Cushing’s disease
hypothyroidism
depression
eating disorders
polycystic ovary syndrome

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9
Q

Genetic disorders that can lead to obesity include

A

Prader-Willi syndrome
Bardet-Biedl syndrome

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10
Q

Which food corresponds with the MOST pathologic form of fat accumulation?
a. apple
b. carrot
c. pear
d. watermelon

A

a. apple

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11
Q

Adipose in the body is used as

A

a readily available energy supply
an insulator

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12
Q

Adipose becomes pathologic when it releases

A

significant quantities of free fatty acids and cytokines

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13
Q

A terminal consequence of excess adipose tissue is

A

insulin resistance and inflammation throughout the body

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14
Q

Android obesity is associated with an increased risk of

A

ischemic heart disease
hypertension
dyslipidemia
insulin resistance
death

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15
Q

Patients with gynecoid fat accumulation are more likely to develop

A

joint disease
varicose veins

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16
Q

Which type of adipose distribution is more common in men?

A

android obesity
gynecoid- more common in women

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17
Q

Android obesity is defined as a waist size

A

> 40 inches for men
35 inches for women

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18
Q

Diagnosis of metabolic syndrome requires at least three of the following signs:

A

fasting plasma glucose >110 mg/dL
abdominal obesity (>40 in in men and >35 in in women)
serum triglyceride level >150 mg/dL
serum HDL <40 mg/dL in men and <50 mg/dL in women
blood pressure >135/85 mmHg

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19
Q

A patient weighs 176 pounds and stands 74 inches tall. Calculate this patient’s body mass index.

A

22.59 kg/m^2

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20
Q

BMI is equal to

A

weight (kg)/ height (m^2)

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21
Q

Overweight is defined as a BMI of

A

25-29.9

22
Q

Class 1 obesity is defined as a BMI of

A

30-34.9

23
Q

Class 2 obesity is defined as a BMI of

A

35-39.9

24
Q

Class 3 obesity is defined as a BMI of

A

> 40

25
Q

In children, severely obese is considered to be

A

weight in the 99th percentile

26
Q

In children, obese is considered to be

A

weight in the 95th-98th percentile

27
Q

In children, overweight is considered to be

A

weight in the 85th-94th percentile

28
Q

How do you convert height from inches to centimeters?

A

1 in= 2.54 cm

29
Q

Underweight for adults is considered to be

A

BMI <18.5

30
Q

Calculate the IBW for a woman who is 5 feet 3 inches tall.

A

55 kg

31
Q

How do you calculate IBW for men and women?

A

men (kg)= height (cm)-100
women (kg)= height (cm)-105

32
Q

Which factors are reduced by obesity? (select 2)
a. vital capacity
b. expiratory reserve volume
c. closing volume
d. residual volume

A

a. vital capacity
b. expiratory reserve volume

33
Q

Obesity produces a ____ ventilatory defect

A

restrictive

34
Q

FRC is inversely proportional to

A

BMI

35
Q

Patients who are obese have a reduction in FRC that is below

A

closing capacity causing distal airway collapse during tidal breathing

36
Q

Patients with obesity have an increased

A

oxygen consumption and CO2 production

37
Q

To compensate for obese patient’s increased oxygen consumption,

A

minute ventilation must be increased

38
Q

General anesthesia causes FRC to fall by

A

50%

39
Q

Patients who are obese have ______________during apnea.

A

rapid desaturation

40
Q

An elevated PaCO2 in the obese patient signals

A

impending respiratory failure

41
Q

Lung volumes that are decreased in the obese patient include

A

vital capacity
total lung capacity
functional residual capacity
expiratory reserve volume

42
Q

What is the optimal tidal volume for a patient with class 3 obesity?
a. 6-8 mL/kg IBW
b. 6-8 mL/kg total body weight
c. 10-12 mL/kg IBW
d. 10-12 mL/kg TBW

A

a. 6-8 mL/kg IBW

43
Q

How should obese patients be preoxygenated?

A

100% FiO2 + CPAP 10 cm H2O until end-tidal O2 >90%

44
Q

What tidal volume should be used for obese patients?

A

6-8 mL of IBW

45
Q

How should you manage PaCO2 for the obese patient?

A

increase the RR- don’t increase tidal volume

46
Q

Obese patients are at risk for

A

post-induction atelectasis

47
Q

Preventative strategies for post-induction atelectasis include

A

FiO2 <80%
alveolar recruitment maneuvers
PEEP

48
Q

Obesity alone does not mandate

A

RSI

49
Q

___________ may occur immediately after extubation or up to 2-5 days following surgery

A

Postoperative hypoxemia

50
Q

Patients with __________ are at the highest risk of postoperative hypoxemia.

A

OSA

51
Q

How should the obese patient be intubated and extubated?

A

in the reverse Trendelenburg position- relieves pressure on thorax and improves FRC

52
Q

Strategies to maximize postoperative oxygenation include:

A

CPAP or BiPAP after extubation
elevate the head of the bed to 30 degrees
early ambulation
control surgical pain- non-opioid analgesics and regional anesthesia will minimize respiratory depression
incentive spirometry

Apex Review (224 decks)

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