Assessment Evaluation

Question 1

Intracranial hypertension/pseudotumor cerebrii
Some common symptoms
visual - 4
other - 2 ear and brain

Answer 1

Floaters,
Brief visual black-outs associated with position changes,
Retrobulbar pain and mild pain with eye movement or globe compression
Diploplia - intermittent or constant

Pulsatile tinnitus

Headaches

Question 2

Intracranial hypertension

Signs (not symptoms)

Answer 2

papilledema
Visual field loss, then acuity loss
6th nerve palsy (impaired eye abduction)

Question 3

Meralgia paresthetica

Symptoms/cause

Answer 3

Tingling, numbness,burning due to compression of Lateral femoral cutaneous nerve

Question 4

What BMI should be used in Asians to screen for T2DM?

Answer 4

BMI>23

Question 5

Most commonly used body fat analysis method

Answer 5

Bioelectrical impedance

Question 6

abdominal circumference obesity cutoffs in Asian

Answer 6

men >90 cm, women >80 cm

Question 7

American Council on Exercise Classification Obesity cutoff for percent body fat
OMA 30/35

Answer 7

Men >25%, Women>32%

Question 8

Neck circumference cutoffs

Answer 8

Men >17, women >16

Question 9

Russell’s sign ( bulemia)

Answer 9

Calluses/abrasions on dorsum of hands/thumbs

Question 10

Kaposi-Stemmer’s sign - how to perform, significance

Answer 10

Ability to pinch skin of 2nd toe - if able to , negative, and no lymphedema

Question 11

which organ has the highest metabolic rate?

Answer 11

liver

Question 12

Total energy expenditure= Resting EE, Thermic effect of meals and EE from physical activity. How much do those contribute (%)

Answer 12

Resting 60-75%
EE from PA -15-30%
Thermic effect of meals 10%

Question 13

Obesity EKG abnormalities 5

Answer 13

Left axis deviation
T wave
PACs ( OSA)
Hypertrophy
QT abnormalities

Question 14

What is Dercum’s disease?

Answer 14

Multiple painful lipomas, on trunk,arms,legs

Can get hand and foot swelling

Question 15

Definition of Metabolically Obese, normal Weight

Answer 15

BMI 20-27
Gained 2-10 kg adipose 
Insulin resistance,high insulin
High TG
Elevated glucose

Question 16

What are the common mechisms for oxalate kidney stone formation?

Answer 16

Increased intestinal absorption oxalate (nuts,legumes,spinach), caused by excess intake and decreased dietary Ca intake.
Dietary Ca may bind to intestinal oxalate, reducing oxaluria.

Question 17

How does obesity increase the risk of uric acid kidney stones?

Answer 17

Insulin resistance alters renal acid-base balance, LOWERS urine PH and increases risk of uric acid stones.
Also intake of animal proteins, salt and highly processed foods.

Question 18

How may orlistat increase the risk of kidney stones?

Answer 18

By binding of intestinal calcium by unabsorbed fat, therefore allowing for higher levels of oxalate for intestinal absorption.

Question 19

How does bariatric surgery increase risk of kidney stones?

Answer 19

Fat malabsorption, which similarly may bind calcium leading to higher oxalate.

Question 20

How does topiramate increase risk of CaPO4 stones?

Answer 20

It increases urinary pH

Question 21

Which drugs can cause positive testing for amphetamines?

Answer 21

fluoxetine
metformin
bupropion
lisdexamfetamine
phentermine

Question 22

Based

on epidemiologic data, the WHO has proposed the following weight classifications in adult Asians:

Answer 22

. BMI <18.5 kg/m2
indicates underweight, 
18.5 to 22.9 kg/m2 normal weight,
23 to 24.9 kg/m2 overweight, 
25 to 29.9 kg/m2 obese class
I
 ≥30 kg/m2 obese class II

Question 23

What is impact on mortality of bariatric surgery?

Answer 23

SOS - 30% lower mortality rate at 10 years

Adams - 40% (60%cancer related,92%DM related)

Question 24

What is Gourmand Syndrome?

Answer 24

Results from damage to Right frontal lobe, characterized by new obsession with gourmet food. Treatment is counselling.

Question 25

Classification of NAFLD

Answer 25

5-33% fat mild
34-66% moderate
>66% severe
Ballooning degeneration detemines presence of NASH