Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

FIMC > Obesity & Geriatrics > Flashcards

Obesity & Geriatrics Flashcards

(49 cards)

Start Studying
1
Q

What is Brocas formula? (2)

A
  1. Calculates IBW
  2. Men = height (cm) - 100
    Women = height (cm) - 105
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is adjusted bodyweight calculated?

A

IBW + 40%

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

What changes do you find in respiration in obese patients? (6)

A
  • Reduced functional residual capacity (from normal of 2L to 1L if BMI >40)
  • increased atalectasis
  • resting metabolic work, working of breathing of minute oxygen demand higher
  • Therefore will desaturate rapidly when apneoc
  • Can also have ‘wheeze’ do to airway closure
  • OHA/OHS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In terms of type of obesity, what is more high risk?

A

Central obesity (waist > 50% height)
- increased airway/ventilation risk
- increased CVS disease
- increased metabolic syndrome

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

What occurs to the cardiovascular system in obesity?

A

SV/CO/blood volume all increase leading to both pulmonary and systemic HTN

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

What is the max load of a scoop?

A

227 kg

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

What is the max load of a normal stretcher?

A

191kg (30 st)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the max load of a bariatric stretcher?

A

268kg (50 st)

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

What drugs use lean body weight (or IBW)? (8)

A
  1. Propofol induction
  2. Ketamine
  3. Non-depolarising paralytics (rocuronium)
  4. Morphine
  5. Fentanyl/alfentanil
  6. Paracetamol
  7. LA
  8. Thiopentone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What medication use adjusted body weight? (4)

A
  1. Propofol infusion
  2. Gentamicin/antibiotics
  3. Suggamadex
  4. Neostigmine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What medications use total body weight? (3)

A
  1. Suxamethonium
  2. LMWH
  3. Midazolam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What BMI equates to:
1. Underweight
2. Healthy weight
3. Overweight
4. Obese
5. Class 1 obesity
6. Class 2 obesity
7. Class 3 obesity

A
  1. < 18.5 kg/m2
  2. 18.5-24.9
  3. 25-29.9
  4. > 30
  5. 30-34.9
  6. 35-39.9
  7. > 40
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is BMI calculated?

A

Weight (kg) / height (m)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which class of weight has highest mortality?

A

Underweight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is central adiposity measured?

A

Waist:height ratio

Waist (cm or inch) / height (cm or inches)

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

In both children/adults and women/men <35 BMI, which waist:height ratio is: (NICE)
1. Healthy
2. Increased central adiposity
3. High central adiposity

A
  1. 0.4-0.49
  2. 0.5-0.59
  3. > 0.6

i.e. your waist should be less than half of your height

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

How does WHO define central obesity in:
1. men
2. women
3. Asian population

A
  1. Waist > 102cm
  2. Waist > 88cm
  3. > 90cm men, > 80cm women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What measurement is used for central adiposity/obesity in:
1. NICE
2. WHO

A
  1. Waist:height ratio
  2. Measurement waist in cm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why do we ramp patients?

A

Increases FRC and reduces risk of aspiration

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

Why do obese patients have increased risk of awareness during RSI?

Study These Flashcards
A

Larger volume of distribution so IV induction agents rapidly redistribute (increased FW) - initial affect similar to non-obese but will last less long and therefore should be quickly followed up with maintenance

21
Q

What is total body weight?

Study These Flashcards
A

TBW = LBW (lean body weight) + FW (fatty weight)

22
Q

How is lean body weight calculated?

Study These Flashcards
A

Complex calculation (few different ones)

23
Q

What is:
- TBW
- LBW
- IBW
- ABW

Study These Flashcards
A
  1. LBW + FW
  2. LBW = patients weight excluding fat
  3. What patient should weight with normal lean:fat mass
  4. Takes into account obese patients have an increase lean body mass and increased volume distribution drugs
24
Q

What type of weight should be used for emergency drugs (adrenaline/noradrenaline)

25
What weight calculation should be used to calculate TV
IBW
26
What percentage of the population are obese and what population is class 3 obesity?
25% and 3%
26
What are the components of metabolic syndome?
- HTN - insulin resistance - high cholesterol - central obesity
27
What is the triad that makes OHS?
1. BMI >35 2. OSA 3. Chronic daytime hypercapnia (>6Kpa)
28
What are the CV changes seen in the elderly? (7)
1. Increased SVR secondary to decreased compliance of medium/large vessels. 2. Reduced response to adrenaline/metaraminol secondary to the above 3. LVH secondary to HTN and impaired diastolic filling secondary to collagen/fibrous deposition 4. Pre-load increases initially to maintain CO however heart now works on flatter part of Starling curve therefore decreased physiological reserve 5. Downregulation of myocardial catecholamine receptors therefore decreased response to catecholamines and sympathominetic agents. Decreased maximal HR and CO with age as a result 7. Fat infiltration/fibrosis leads to decreased functioning of cardiac conducting pathways leading to increased AF etc.
29
Describe the respiratory changes that occur in elderly patients
1. Reduced airway elastance, lung compliance and chest wall compliance 2. Total lung capacity, FVC, FEV1 and vital capacity all reduce 3.Conversely residual volume and therefore FRC increase leading to Increased tendency of the alveoli and terminal airway collapse 4. Decreased chemoreceptor function leading to decreased response to hypoxia/hypercapnia 5. Loss of airway tone and cough reflex 6. Increased OSA
30
What is 'Time Up and Go?'
Used to measure mobility in elderly - take to stand up, walk 3 m, turn around and return to sit back in chair
31
Describe the clinical frailty score (9)
32
What lung ventilation strategies should we use in the obese patient? (3)
1. Lung protective volumes (6-8ml/kg IBW) 2. plateau pressures <30cmH2O 3. titrate PEEP accordingly (high levels recommended 8-10cmH2O).
33
How should tidal volumes be calculated in the obese patient?
IBW
34
Where is the intercristal (line between superior aspect of both ASIS) line level obese patients?
L4-5 (same as normal patient)
35
What can be used to help identify shock in elderly trauma patients to allow for their different physiological parameters?
Age adjusted shock index = age x HR/SBP If age-adjusted shock index > 50: suspect shock or occult shock
36
What percentage of falls lead to signicant injury in the elderly?
10%
37
What is the main initial disadvantage elderly patients face in our current trauma system and how can we try to balance this?
Triage tool poor sensitivity for elderly trauma - under triage MDT approach can lead to outcomes being similar to younger patients
38
With regards to polypharmacy? 1. What is the definition? 2. What % of admissions related to it? 3. What is the average number of medications elderly patients take?
1. 5 or more medications 2. 25% 3. 4-6
39
What does the BNF say with regards to NSAIDS in the elderly?
Can be given if needed but should try paracetamol/exercise etc. first for pain
40
What is the generic advice in the BNF with regards to prescribing in the eldery?
Start at 50% adult dose and titrate up
41
What is the most important age related factor in response to medications?
Reduced renal clearance
42
What is the consequence of reduced liver clearance in the elderly in terms of pharmacology?
Lipid soluble (hydrophobic) medication is excreted slowly
43
What 4 examples of lipid soluble (hydrophobic) medications used in the elderly?
1. CCB 2. Beta blockers 3. NSAIDS 4. Propofol
44
Why are hydrophillic drugs unlikely to be significant effected by excess adipose tissue?
- High plasma concentration relative to dose, and a smaller volume of distribution. - Therefore remain in extracellular fluid and volume of distribution correlates with lean mass
45
Why are lipophillic (lipid soluble) drugs more likely to correlate with total body weight?
Distribute more readily into adipose tissue, resulting in lower plasma concentrations and a larger volume of distribution.
46
In general, what type of body weight calculation should the following medications use? 1. Hydrophillic 2. Lipophillic
1. IBW 2. TBW
47
What occurs in terms of hepatic drug metabolism in the elderly?
Reduced first pass metabolism
48
Where is the angle of Louis in a bariatric patient?
2nd costal cartilage (same as non-bariatric)

FIMC (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions