Childhood Obesity

Question 1

obesity rate for children ages 2-19 by race and ethnicity

Answer 1

1. latinos
2. african american
3. caucasians
4. asians

Question 2

economic costs of obesity

Answer 2

1. increased health care utilization in obese children/adolescents
2. living longer with obesity and comorbidities
3. increased hospital care costs
4. cost of equipment and technology

Question 3

environmental factors contributing to childhood obesity

Answer 3

1. sugar sweetened beverages
2. sedentary lifestyle
3. screen time >2 hrs
4. decrease sleep

Question 4

medications contributing to childhood obesity

Answer 4

1. psychoactive drugs
2. antiepileptic drugs
3. glucocorticoids

Question 5

endocrine disorders contributing to childhood obesity

Answer 5

1. hypothyroidism
2. GH deficiency
3. Cushing syndrome
4. damage to CNS-trauma
5. tumor

Question 6

genetic etiology of childhood obesity

Answer 6

1. Prader Willi syndrome
2. Down syndrome
3. Turner syndrome
4. Leptin deficiency
5. genetic deletions

Question 7

children with genetic syndromes associated with obesity

Answer 7

1. have early-onset obesity
2. dysmorphic features
3. short stature
4. developmental delay
5. intellectual disability
6. retinal changes
7. deafness

Question 8

Leptin deficiency

Answer 8

1. early onset morbid obesity
2. high fat mass
3. infertility
4. T-cell defects recurrent infections

Question 9

T/F: Leptin deficiency is rare and autosomal recessive

Answer 9

true

Question 10

tx of Leptin deficiency

Answer 10

rx with recombinant leptin

Question 11

Leptin receptor deficiency

Answer 11

1. milder phenotype

2. no specific rx

Question 12

what is the key determinant to childhood obesity?

Answer 12

energy balance

decrease in physical activity + increased calorie intake = shift in energy intake and energy expenditure

Question 13

factors affecting energy balance of child

Answer 13

1. parental BMI
2. built environment
3. sedentary lifestyle
4. energy dense nutrient poor foods
5. portion distortion
6. daily conveniences
7. psychological issues

Question 14

T/F: body mass index (BMI) is a reliable tool to assess body fat in children over 2 y.o.

Answer 14

true

Question 15

BMI has clinical validity and easy to measure

Answer 15

true

Question 16

what does BMI correlate with?

Answer 16

body fat and health risks

Question 17

T/F: BMI is a direct measure of percent body fat

Answer 17

false, NOT

Question 18

higher BMI can be a predictor of what?

Answer 18

future adiposity

Question 19

T/F: BMI distribution changes as children grow and develop

Answer 19

true

Question 20

underweight

Answer 20

BMI <5th%

Question 21

normal weight

Answer 21

BMI between 5th and <85th%

Question 22

overweight

Answer 22

BMI 85th to 95th%

Question 23

obese

Answer 23

BMI ≥95th%

Question 24

severe obesity

Answer 24

BMI ≥120% of the 95th% values OR a BMI ≥35 kg/m^2 (whichever is lower)

Question 25

acanthosis nigricans

Answer 25

1. sign of insulin resistance 2. velvety texture 3. may fade with weight loss

Question 26

obesity and dental implications

Answer 26

1. fermentable carbs convert into simple sugars in mouth 2. simple sugars can be converted into plaque 3. as plaque accumulate, teeth and gums increase risk for gingivitis, periodontitis and tooth decay

Question 27

why is there an increased likelihood of perio disease in obese patients?

Answer 27

due to an increased proinflammatory environment involving IL-8, TNF-alpha

Question 28

baseline for childhood obesity management

Answer 28

prevention plus primary care office for ALL patients

Question 29

stage 1 for childhood obesity management

Answer 29

primary care provider office

Question 30

stage 2 for childhood obesity management

Answer 30

primary care office with allied health provider (i.e. dietitian)

Question 31

stage 3 for childhood obesity management

Answer 31

intensive care with multidisciplinary team

Question 32

stage 4 for childhood obesity management

Answer 32

1. bariatric surgery 2. very low calorie diets 3. medications

Question 33

3 levels of physical activity

Answer 33

1. organized/team activity 2. family activity 3. me-directed activity

Question 34

benefits of early surgical intervention for weight loss

Answer 34

1. lower operative risk 2. earlier resolution of comorbidities 3. lower achievable weight loss 4. earlier improvement in depression and quality of life measures

Question 35

earlier resolution of comorbidities

Answer 35

1. improved life expectancy 2. decreased insulin resistance spares beta cells from "burn out" 3. improved diastolic fxn and cardiac geometry

Question 36

weight loss surgery types

Answer 36

1. gastric bypass 2. gastric sleeve 3. adjustable gastric band

Question 37

gastric bypass

Answer 37

restrictive and malabsorptive

Question 38

gastric sleeve

Answer 38

restrictive only

Question 39

adjustable gastric band

Answer 39

restrictive and adjustable