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Flashcards in Obesity Deck (11):
1

define Obesity

BMI greater than 95th percentile for age.
Overweight >85%

2

Differentiate nutritional obesity from other causes

Nutritional obesity - these children are overweight and tall
Endocrine causes - overweight and short
Genetic causes and learning difficulties - overweight from a young age, short and have dysmorphic features

3

Ix for obesity

only for children who are overweight, short and have dysmorphic features or learning difficulties require further investigation looking for underlying aetiology.
Look for cause - T4, TSH, Urnary free cortisol, Karyotype and DNA analysis (Genetic eg prayer Willi syndrome), MRI of brain.
Look for consequences - Urinary glucose or oral glucose, Fasting lipid, LFT.

4

Ix for obesity

only for children who are overweight, short and have dysmorphic features or learning difficulties require further investigation looking for underlying aetiology.

5

Causes of obesity

Nutritional obesity - due to lifestyle factors, Increase sedentary, decrease physical and increase energy dense foods.
Endocrine cause
- Hypothyroidism
- Cushing's
- Hypothalamic lesion
Genetic syndromes and single gene defects 9rare)
- not finished

6

Describe principles of life-style management of obesity

Needs to be holistic, family focused and delivered in a skilled way that builds motivation.
Includes:
Support for any bullying or psychological disturbance due to obese
Encouraging physical activity and reducing sedentary behaviour
A balanced healthy diet- no crash diet, aim for weight maintenance
Monitoring for comorbidity and mx
Restrict TV to 1 HR a day

7

Consequence of obesity in children

Low self esteem
School problems - bullied and bullies
Orthopaedic - MSK strain and SLIPPED CAPITAL FEMORAL EPIPHYSES
Asthma
Sleep apnoea
Polycystic ovary syndrome
Impaired glucose tolerance - diabetes
HTN
Dyslipidaemia
Abnormal liver function tests.

8

Name some population interventions that have been used to prevent obesity.

Breast feeding in infancy is protective
Promotion of good nutrition in the early years when food habits are developing
Physical activity need to encourage in all children
Active Q about these especially in adolescence. When high intake of high fat foods and decrease exercise is common.

9

Hx Q for children with obesity

Lifestyle and diet
Emotional and behavioural problems eg social and school problems, depression and bulling
Complications - MSK symptoms due to increase load on joints, Snoring, lethargy or tiredness for sleep apnoea, Diabetes and CVS
Learning difficulties - genetic cause
Symptoms - endocrine eg Hypothroidism and cushing's
Fm Hx - Obesity, early onset T2D, Heart disease

10

EX for child obesity

Growth - If tall = Nutritionally obese. If short or fall-off = pathological cause. Calculate BMI and plot
Endocrinology signs - In poor growth look for signs of Hypothroidism (Goitre, developmental delay, slow tendon reflexes, bradycardia), Steroid excess (moon face, buffalo hump, striae, HTN, bruising).
Sign of Dysmorphic syndromes - short stature, microcephalic, hypogonadism, hypotonia and congenital anomalies.
Signs of complications - BP, acanthosis nigricans.

11

Cx of sleep apnoea

Increased lung perfusion
Increased BP
Increased RVH
Tachycardia