39 - 45 yo man who is overweight Flashcards Preview

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Flashcards in 39 - 45 yo man who is overweight Deck (20)
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1
Q

patients with a BMI over ____ have higher death rates from several types of cancer

A

40

2
Q

metabolic syndrome: criteria

A

3/5 of:

  • fasting plasma glucose
  • BP over 130/85
  • Trigs over 150
  • HDL under 40 (men) or 50 (women)
  • waist circumference over 40” men, 35” women
3
Q

what is believed to be the underlying mechanism of metabolic syndrome?

A

insulin resistance

4
Q

what is the pooled cohort equation?

A

predicts atherosclerotic cardiovascular events that are reduced by statin therapy

5
Q

which 4 groups are likely to benefit from statin therapy?

A
  • current ASCVD
  • LDL over 190
  • DM 1 or 2 age 40-75
  • estimated 10 year ASCVD risk by pooled cohort equation over 7.5%
6
Q

bile acid sequestrants such as cholestyramine have a more modest effect on lowering ______ and raising ______ but can cause an increase in _______________

A
  • LDL
  • HDL
  • trigs
7
Q

what is first line therapy for reducing trigs? what is the downside? what is an added benefit?

A
  • fibric acid derivatives
  • modest effect on reducing LDL
  • can increase HDL 10-20%
8
Q

what is the MOA of ezetimibe? is there evidence of benefit for ASCVD?

A
  • inhibits absorption of cholesterol at intestinal brush border, increases cholesterol clearance
  • no benefit in prevention of ASCVD
9
Q

high intensity statin therapy is reserved for what groups?

A
  • patients under 75 with clinical ASCVD and no safety concerns
  • LDL over 190
  • diabetics 40-75 with estimated 10 year ASCVD risk over 7.5
10
Q

moderate intensity statin therapy is reserved for what groups?

A
  • patients over 75 with clinical ASCVD

- diabetics 40-75 with estimated 10 year ASCVD risk under 7.5

11
Q

what are the side effects of statins?

A
  • hepatic dysfunction (check LFTs)

- myopathy

12
Q

EQUATION: caloric intake needed to maintain current weight = ?

A

basal metabolic rate + additional calories for activity

  • BMR = body weight (lbs) x 10
  • additional calories: body weight (lbs) x _____
  • 1.3 if sedentary
  • 1.5 for moderate activity
  • 1.7 for heavy activity
  • 1.9 for intense activity
13
Q

a patient needs to have approximately a ______ calorie DEFICIT in order to lose 1 lb of weight

A

3500

14
Q

what is the MOA of orlistat?

A
  • lipase inhibitor

- decreases fat absorption

15
Q

what is the MOA of phentermine?

A

noradrenergic appetite suppressant

16
Q

what is the MOA of lorcaserin?

A
  • highly selective serotonergic receptor agonist

- appetite suppressant

17
Q

what is the major side effect of lorcaserin?

A

hypoglycemia in diabetic patients

18
Q

qsymia is a combination of _________ and ________

A

phentermine and topiramate

19
Q

contrave is a combination of _________ and _________

A

naltrexone and buproprion

20
Q

what are the indications for bariatric surgery?

A
  • BMI over 40

- BMI over 35 with severe health complications who have not succeeded in losing weight with other methods