Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med II Final > Obesity > Flashcards

Obesity Flashcards

1
Q

BMI

A

describes body weight relative to heigh; best estimate to determine: underweight, healthy, overweight or obese

strongly correlated w/ total body fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Calculation of BMI

A

BMI = Weight (kg) / height (m^2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Overweight BMI

A

25-29.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Obesity class I

A

30-34.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Obesity class II

A

35-39.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Obesity class III

A

> 40 (severe obesity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Measurements for check up

A 
BMI
Waist circumference (if BMI b/w 25-35)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Increased risk for weigh circumference

A

> 40 for men

>35 for women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

risk of weight circumference

A

abdominal obesity increases cardiometabolic risk (CAD, DM, HTN, HLD, NAFLD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ethnic variability for waist circumference

A

35.4 male
31.5 female
for ASIANS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

cancers associated w/ obesity

A

endometrial
kidney
breast
color

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how to lose 1-2 lbs per week

A

create 500-1000 calorie per day deficit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Eval for obesity

A 
hx and PE
fasting glucose and/or HbA1C
TSH
liver enzymes
fasting lipids
sleep apnea?
meds?
recent smoking cessation?
CV risk factors?
OA?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Old food pyramid

A 
bread/cereal/rice/past: 6-11 servings
fruit- 2-4
veggies 3-5
meat/nuts/eggs: 2-3
Milk/yogurt/cheese: 2-3
Fats/oils/sweets: sparingly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

New pyramid

A

includes exercise
limit oils/saturated fats, trans fats, sodium
low added sugar
more individualized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MyPlate

A

fruits, grains, veggies, protein, dairy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

diets for weight loss and DM and CAD protection

A

DASH

Mediterranean

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

DASH diet

A

emphasis: veggies, fruit, low-fat dairy
Moderate: whole grains, fish, poultry, nuts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mediterranean diet

A

mainly plant based: fruits, veggies, whole-grain breads, cereals, beans, nuts, seeds
Principle source of fat: olive pil
Fish, poultry. limit red meat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

T II DM diets

A

DASH, mediterranean, carb counting, limit sugar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CVD diets

A

Dash, low Na, mediterranean

22
Q

Kidney disease

A

DASH, renal diet

23
Q

Celiac disease

A

gluten free diet

24
Q

Benefits of physical acivity

A

reduced risk of cancer
brain health
reduced risk of falls
improved quality of life

Immediate: reduced feelings of anxiety and BP, improved sleep, cognitive function, insulin sensitivity

Long term: cardiorespiratory fitness, muscle strength, decreased depression, sustained reduction in BP

25
Q

Screening for obesity

A

screen ALL adults

BMI >30: refer for intensive, multicomponent behavioral intervention (2 x month for >3 months, 12-36 sessions a year)

26
Q

How often should you do behavioral intervention?

A

2 x/month for >3 mo

12-26 x a year

27
Q

Counseling 5 A’s

A

ask/address: weight, nutrition, exercise; address BMI and weight circumference

advise: provide clear, strong advice
assess: assess readiness to change (motivation, past experiences)

Assist: provide brief counseling or self help material; referral/resources

Arrange: follow up (call in 2 wks, f/u in 4)

28
Q

Goal of obesity tx

A

prevent, treat or reverse the complications of obesity

29
Q

Who is a candidate for weight loss intervention

A

BMI >25

30
Q

Tx based on risk

A

low risk (25-29.9) (w/ no CVD RF or other comorbidities: diet/exercise

Mod risk (25-29.9 AND >1CVD RF or BMI 30-34.9) - intensive, multicomponent behavioral mod (diet/exercise and maintain weight loss) and SOME…drugs

High risk (35-40) and VERY HIGH RISK (BMI >40): behavioral mod and consider drug tx, bariatric surgery

31
Q

When to consider drug therapy

A

BMI >30 or >27 w/ comorbidities

comprehensive lifestyle program is always 1st line! - if weight loss <5% in 3-6 months consider drugs

32
Q

Goals of drug therapy

A

reduce weight (4-8% in 6-12 mos)
improve health
minimize adverse effects

33
Q

Obesity drugs

A 
Orlistat
Liraglutide
Lorcaserin
Phentermine/topiramate
Phentermine
34
Q

Orlistat

A

alters fat digestion by inhibiting pancreatic lipases

SE: increased fat in stool, may decrease absorption of fat soluble (ADEK) vitamins – MV; “unpleasant” GI effects

35
Q

Liraglutide

A

GLP-1 Receptor Agonist
Daily SQ injection

SE: N/V (common)

  • common choice in Type 2 DM
36
Q

Lorcaserin

A

serotonin agonist
decreases appetite
limited safety data

37
Q

Phentermine/topiramate

A

not in pts w/ HTN, CAD, hyperthyroidism

38
Q

Phentermine

A

sympathomimetic
not in HTN, CAD, hyperthyroidism
only short term use (12 weeks)

More SEs. Potential for abuse

39
Q

Most widely prescribed drug

A

Phentermine

40
Q

Monitoring for drug therapy

A

weight, BP, HR and SE’s
- weekly for 4 weeks, then monthly for next 3-4 months

monitors SE: hypoglycemia, neuropsych (lorcaserine, phetermine-topiramate)

41
Q

When to d/c drugs

A

if 4-5% weight loss not obtained after 3 months – switch meds?

42
Q

Therapies NOT recommended

A

ingredients

Garicinia/Hydroxycitric (HCA) – hepatitis, mania, rhabdo, serotonin syndrome

43
Q

When to consider bariatric surgery

A

BMI >40
BMI 35-39.9 + >1 serious comorbidity
BMI 30-34.9 + difficult to control type 2 DM or metabolic syndrome

44
Q

Weight loss before surgery

A

loss of 8% of excess body weight prior to surgery leads to greater weight loss post op

45
Q

Contraindications for bariatric surgery

A 
eating disorder
untreated mental illness
drug or ETOH abuse
Coagulopathy
severe cardiac disease
inability to comply w/ lifelong dietary requirements
46
Q

How does bariatric surgery effect weight loss

A

restriction - reduce stomach capacity
malabsorption
some decrease appetite and improve metabolism by changing hormone release

47
Q

Types of bariatric surgery

A

sleeve gastrectomy - less capacity, less ghrelin

adjustable gastric band - rarely performed; saline injected to constrict

Roux-en-Y Gastric bypass: fullness after consuming small amount- decreased appetite and improved metabolism (changes hormone release)

48
Q

Physical activity vital sign

A
  1. how many days/week (>brisk walk)
  2. How many minutes on those days?

GOOD: 150-300 min/wk

49
Q

Physical activity guidelines

A 
150-300 min/wk of moderate intensity
OR
75-150 min/wk of vigorous intensity 
PLUS
Muscle strengthening >2day/week
50
Q

Exercise prescription

A 
FITT:
Frequency: >5days/week
Intensity: moderate to vigorous
Time: >30 min
Type: walking is great for previously sedentary pt
51
Q

How to determine exercise intensity

A

“talk test”
moderate- can talk but not sing (brisk walk, raking yard)
vigorous- can’t say more than a few words w/o pausing to breath (running, fitness class)

Clin Med II Final (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions