Obesity

Question 1

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

Answer 1

c. 9

Question 2

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

Answer 2

adult obesity

Question 3

Childhood obesity is more common than

Answer 3

diabetes
cystic fibrosis
& all cancers

Question 4

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

Answer 4

4

Question 5

The etiology of obesity is multifactorial and influenced by

Answer 5

social
pharmacologic
pathophysiologic
genetic factors

Question 6

Social causes of obesity include

Answer 6

overeating
poor access to proper nutrition

Question 7

Obesity as a result of medication side effects can be from

Answer 7

steroids
antidepressants

Question 8

Diseases that can lead to obesity include

Answer 8

Cushing’s disease
hypothyroidism
depression
eating disorders
polycystic ovary syndrome

Question 9

Genetic disorders that can lead to obesity include

Answer 9

Prader-Willi syndrome
Bardet-Biedl syndrome

Question 10

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

Answer 10

a. apple

Question 11

Adipose in the body is used as

Answer 11

a readily available energy supply
an insulator

Question 12

Adipose becomes pathologic when it releases

Answer 12

significant quantities of free fatty acids and cytokines

Question 13

A terminal consequence of excess adipose tissue is

Answer 13

insulin resistance and inflammation throughout the body

Question 14

Android obesity is associated with an increased risk of

Answer 14

ischemic heart disease
hypertension
dyslipidemia
insulin resistance
death

Question 15

Patients with gynecoid fat accumulation are more likely to develop

Answer 15

joint disease
varicose veins

Question 16

Which type of adipose distribution is more common in men?

Answer 16

android obesity
gynecoid- more common in women

Question 17

Android obesity is defined as a waist size

Answer 17

> 40 inches for men
35 inches for women

Question 18

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

Answer 18

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

Question 19

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

Answer 19

22.59 kg/m^2

Question 20

BMI is equal to

Answer 20

weight (kg)/ height (m^2)

Question 21

Overweight is defined as a BMI of

Answer 21

25-29.9

Question 22

Class 1 obesity is defined as a BMI of

Answer 22

30-34.9

Question 23

Class 2 obesity is defined as a BMI of

Answer 23

35-39.9

Question 24

Class 3 obesity is defined as a BMI of

Answer 24

> 40

Question 25

In children, severely obese is considered to be

Answer 25

weight in the 99th percentile

Question 26

In children, obese is considered to be

Answer 26

weight in the 95th-98th percentile

Question 27

In children, overweight is considered to be

Answer 27

weight in the 85th-94th percentile

Question 28

How do you convert height from inches to centimeters?

Answer 28

1 in= 2.54 cm

Question 29

Underweight for adults is considered to be

Answer 29

BMI <18.5

Question 30

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

Answer 30

55 kg

Question 31

How do you calculate IBW for men and women?

Answer 31

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

Question 32

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

Answer 32

a. vital capacity b. expiratory reserve volume

Question 33

Obesity produces a ____ ventilatory defect

Answer 33

restrictive

Question 34

FRC is inversely proportional to

Answer 34

BMI

Question 35

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

Answer 35

closing capacity causing distal airway collapse during tidal breathing

Question 36

Patients with obesity have an increased

Answer 36

oxygen consumption and CO2 production

Question 37

To compensate for obese patient's increased oxygen consumption,

Answer 37

minute ventilation must be increased

Question 38

General anesthesia causes FRC to fall by

Answer 38

50%

Question 39

Patients who are obese have ______________during apnea.

Answer 39

rapid desaturation

Question 40

An elevated PaCO2 in the obese patient signals

Answer 40

impending respiratory failure

Question 41

Lung volumes that are decreased in the obese patient include

Answer 41

vital capacity total lung capacity functional residual capacity expiratory reserve volume

Question 42

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

Answer 42

a. 6-8 mL/kg IBW

Question 43

How should obese patients be preoxygenated?

Answer 43

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

Question 44

What tidal volume should be used for obese patients?

Answer 44

6-8 mL of IBW

Question 45

How should you manage PaCO2 for the obese patient?

Answer 45

increase the RR- don't increase tidal volume

Question 46

Obese patients are at risk for

Answer 46

post-induction atelectasis

Question 47

Preventative strategies for post-induction atelectasis include

Answer 47

FiO2 <80% alveolar recruitment maneuvers PEEP

Question 48

Obesity alone does not mandate

Answer 48

RSI

Question 49

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

Answer 49

Postoperative hypoxemia

Question 50

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

Answer 50

OSA

Question 51

How should the obese patient be intubated and extubated?

Answer 51

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

Question 52

Strategies to maximize postoperative oxygenation include:

Answer 52

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