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PT Practice 4 > Bariatrics > Flashcards

Bariatrics Flashcards

1
Q

How many Americans qualify as morbidly obese?

A

6 million

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2
Q

What is bariatrics?

A

Bariatrics is the branch of medicine that deals with the causes, prevention, and treatment of obesity.

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3
Q

True or false; All forms of obesity have only increases in fat cell number and not cell size

A

False; All forms of obesity have both increases in fat cell number and cell size

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4
Q

What % constitutes mild obesity?

A

20-24%

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5
Q

What % constitutes moderate obesity?

A

40-100%

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6
Q

What % constitutes severe obesity?

A

> 100%

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7
Q

What is causing obesity in the US?

A
  • Fewer burned calories
  • Supersize
  • Sedentary behaviors
  • Issues related to children
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8
Q

What BMI constitutes over weight?

A

25

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9
Q

What BMI constitutes class I obesity?

A

30

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10
Q

What BMI constitutes class II obesity?

A

35

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11
Q

What BMI constitutes class III obesity?

A

40

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12
Q

What BMI constitutes the ideal for adults?

A

<24.9%

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13
Q

What BMI constitutes under weight?

A

<18.5%

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14
Q

What BMI constitutes normal for adults?

A

Between 18.5%-25%

I know, I’m sorry, but she broke it all down on the slide

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15
Q

What are some factors for obesity?

A 
Genetics: number and size of fat cells, overweight relatives
Environmental: how much you eat
Culture
Socioeconomic
Psychological
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16
Q

In children, which percentile BMI constitutes underweight ?

A

<5th percentile

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17
Q

In children, which percentile BMI constitutes a healthy weight?

A

5th-84th

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18
Q

In children, which percentile BMI constitutes overweight?

A

85th-94th

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19
Q

In children, which percentile BMI constitutes obese?

A

95th and up

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20
Q

In males, which waist to hip ratio predicts low risk of developing health issues?

A

0.95 or below

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21
Q

In males, which waist to hip ratio predicts moderate risk of developing health issues?

A

0.96-1.00

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22
Q

In males, which waist to hip ratio predicts high risk of developing health issues?

A

More than 1.0

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23
Q

In females, which waist to hip ratio predicts low risk of developing health issues?

A

0.80 and below

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24
Q

In females, which waist to hip ratio predicts moderate risk of developing health issues?

A

0.81-0.85

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25
Q

In females, which waist to hip ratio predicts high risk of developing health issues?

A

Greater than 0.85

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26
Q

What are 4 things visceral obesity may lead to?

A
  • Sleep apnea
  • Arterial oxygen desaturation
  • Cardiovascular events
  • T2DM, impaired glucose tolerance, insulin resistance
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27
Q

What’s another word for impaired glucose tolerance?

A

Prediabeties

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28
Q

True or false; Males store their fat mostly in the lower body and there is an increased NUMBER of fat cells

A

False; Females, mostly lower body and there is an increased NUMBER of fat cells (hyperplasia)

29
Q

True or false; Males store fat mostly in the upper part of body and large increases in cell SIZE are seen.

A

True

30
Q

What is hyperplasia?

A

Increased number of cells

31
Q

What is hypertrophy?

A

Increase in cell size

32
Q

What is the current fat cell theory?

A

Maximum size of adipocytes causes differentiation of presursors to become new adipocytes→hyperplastic growth

33
Q

What are the health risks associated with obesity?

A
  • HTN
  • Blood lipids: reductions in HDL and elevations in triglycerides and total cholesterol
  • CVD
  • DM
  • Gall bladder disease
  • Cancer
  • Other risks
  • Ischemic heart disease
  • Changes in blood sugar in pts. w/DM
  • Respiratory insufficiency
  • Dyspnea
  • Edema
  • Nonalcoholic steatohepatitis
  • Meds (side effects of DM meds); wt. loss meds
34
Q

What makes up the deadly quartet?

A

Obesity
High blood pressure
High cholesterol
Diabetes

35
Q

What are the symptoms of pickwickian syndrome?

A
  • out of breath
  • lack of energy
  • fatigue
  • swelling and cyanosis
  • head aches
  • depression symptoms
36
Q

Lowest mortality rates are seen in people who weigh at ___% of their desired weight

A

90%

37
Q

True or false; Rates of mortality increase with

increasing weight

A

True

38
Q

What are the 2 phases of Dionne’s Bariatric Body Types?

A

The Dependent Phase

The Rehabilitation Phase

39
Q

What are the 2 states that make up Dionne’s Dependent Phase?

A

Anasarca, The Congested State

Weakness, The Fatigued State

40
Q

At which state of Dionne’s Dependent Phase can you start to exercise a patient?

A

Weakness, the fatigued state

41
Q

What are Dionne’s 5 Bariatric Body Types?

A 
Apple Ascites
Apple Pannus
Pear Adduction
Pear Abduction 
Gluteal Shelf
42
Q

What is Apple Ascites?

A

Body fat accumulates anteriorly and centrally on the torso

As per Quizlet:

  • Have a high waist to hip ratio
  • Have significant difficulty in tolerating flat supine and prone postures. Usually
    have several pillows under the head end of the bed to achieve semi-fowler
    position to augment breathing.
  • Hypertrophy of accessory muscles of respiration
  • Has an immobile chest, immobile umbilicus
43
Q

What is Apple Pannus?

A

Body fat accumulates around the torso, but with a flap over the legs

As per Quizlet:

  • Have high waist to hip ratio
  • Patient has a mobile umbilicus
  • Variable supine tolerance
  • May tolerate prone
44
Q

What is Pear Abducted?

A

Body fat accumulates on the inside of the thighs
Lowered COG
Issues with toileting and moisture accumulation

As per Quizlet:

  • Have a very low waist to hip ratio
  • Majority of tissue is below belt line and femur is in abducted posture
  • Severely painful knees due to Valgus stress
  • Move from supine to sit via long sitting and avoid log rolling
45
Q

What is Pear Adducted?

A

Body fat accumulates on the outside of the thigh
Better at rolling than Pear Abducted
Lower COG

As per Quizlet:

  • Low waist to Hip ratio
  • Lower extremities are adducted and in-line with the body
  • Move from supine to sit via long sitting or may seek rolling technique
46
Q

People with Pear (Abducted/ Adducted) body types have a difficult time rolling

A

Abducted

47
Q

What is Gluteal Shelf?

A

Body fat accumulates in the gluteal region
They have a hard time sitting and laying down

As per Quizlet:

  • Mixed Waist to Hip ratio
  • Excessive posterior tissue in gluteal region
  • Limited Supine tolerance
48
Q

What are orlistats? What’s wrong with them?

A

Medication that prevents the absorption of 1/3 of dietary fats, however they may limit absorption of nutrients we need. Side effects include liquidy stool, gassy, discomfort (like IBS)

49
Q

What is sibutramine? What are some of the problems with them?

A

Medication that increases satiation. They affect the parasympathetic nervous system. They may cause HTN and other problems.

50
Q

True or false; Gastric sleeve surgery has fewer side effects than a band surgery

A

True

51
Q

True or false; Gastric selves constrict the fundus of the stomach

A

FALSE; BANDS constrict the fundus

52
Q

True or false; Gastric sleeve surgery involves cutting a piece of the stomach off and sewing it up.

A

True

53
Q

How many ounces of food typically can fit in the stomach post bariatric banding procedure?

A

1-2 oz

54
Q

What is the final outcome in a Gastric Bypass/ Roux en-y surgery?

A

The jejunum is reattached to the fundus

The remaining stomach and duodenum provides digestive juices, which meet the food in the jejunum.

55
Q

_________ syndrome is associated with Gastric Bypass/ Roux en-y surgery.

A

Dumping syndrome- this new arrangement can lead to malnutrition and poor absorption.

56
Q

What are some medical problems to address in the critical bariatric patient?

A
  • CHF
  • Ventilatory pump obstruction
  • Reduced tissue oxygenation
  • Blood sugar
  • Cardiac telemetry
  • Heat dissipation
  • Postural edema deformity
  • Skin
  • Reality based anxiety
  • Bowel/bladder
57
Q

What constitutes the Bariatric Triad?

A
  • A weight-rated expandable support surface bed
  • A weight-rated target wheelchair
  • A weight-rated bedside lift with scale.
58
Q

What 4 things make up Dionne’s key for conveyance?

A
  • Portability (of equipment)
  • Storage ability
  • Skill ability (caregiver safety and not too technical)
  • Infection control ability
59
Q

True or false; bariatric patients are often stronger relative to body mass compared to average weight persons

A

False

60
Q

True or false; you can measure someone for a wheel chair in supine

A

True

61
Q

In a bariatric wheel chair, the axial may be moved a couple inches ________ due to the individual’s shifted COG.

A

Anterior

62
Q

Which medical indications might require a hard seat application?

A
  • presence of neurologic disease with spasticity
  • post stroke or other forms of paralysis
  • severe orthopedic deformity.
63
Q

What is the typical weight restriction for a standard size cane? Heavy duty straight and quad canes?

A

Standard: 250lbs

Heavy duty: 500lbs

64
Q

Which type of grip involves twisting a sheet around a patient’s waist and wrapping it around your forearm for support?

A

Reverse grip

65
Q

What are the components of an egress test?

A

2 person assisted s2s (or weight on their feet) x3

Taking steps in place 10-20x

Stepping forward and backward

66
Q

How do you perform an assisted scoot?

A

• Sheet around upper buttocks, tip of seat surface
• Have patient forcefully flex UEs while extending head and neck to move chin up
• Gently assist sheet allowing hips to move forward
• Guard patient’s knees
______
“Raise your arms up forcefully to move up in a chair”

Think Flashdance, but with their arms in the air and a sheet under their bottom, and you pull.

67
Q

What are ACSM’s reccomendations for obesity and exercise?

A
  • Low intensity aerobic activity progressively increasing duration. Initially frequency and duration is more important than intensity
  • 4-5 days per week
  • 30-60 minutes
  • Resistance training
  • Have a warm up
68
Q

What are some nice activities to do with Bariatric patients?

A
  • Walking
  • Swimming
  • Water exercise
  • Cycling

PT Practice 4 (13 decks)

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