CSOWM Deck 4

Question 1

Prader Willy and Cushing’s Syndrome are ?

Answer 1

Genetic Obesity conditions seen in children.

Question 2

When should liver problems be assessed in children?

Answer 2

Bi-Annually check AST/ALT @10 years old if they are >95% for weight or 85-99.99 with other risk factors.

Question 3

The difference in documentation of wts between CDC and IOFC?

Answer 3

CDC charts in percentiles, IOFC is for adults only.

Question 4

The leading causes of death in Obese people include?

Answer 4

Cancer, Ischemic heart disease, T2DM , Respiratory.

Question 5

For adults the Intervention strategy, BMI cutoff’s and for medication are?

Answer 5

Diet, exercise, behavior : BMI >25
Diet, exercise, behavior + Med’s >27 with comorbidities.
Diet, exercise, behavior + Med’s >30

Question 6

Bariatric surgery BMI qualifiers for kids are?

Answer 6

BMI >35 with 2 major co-morbidities or BMI >40 and less major co-morbidities.

Question 7

Bariatric surgery BMI qualifiers for adults are?

Answer 7

BMI >35 with co-morbidities or >40

Question 8

ADA recommends that FBG test should be taken if the a child is overweight and has 2 additional risk factors. At what age should screening begin? How often should they be tested?

Answer 8

10 years old or puberty and then tested every 2 years

Question 9

What are strong indicators for early bariatric surgery in adolescents?

Answer 9

Moderate to severe OSA
NASH (non alcoholic steatohepatitis)
Pseduotumor cerebri

Question 10

Weak indicators for early bariatric surgery in adolescents?

Answer 10

CVD risk factors, Metabolic syndrome, Quality of life, depression, ED (but ED should be treated first)

Question 11

With an adolescent having bariatric surgery what deficiencies should be monitored?

Answer 11

This is an important time of growth so bone mass accumulation. Calcium and Vitamin D. Higher risk for Thiamine Defiency, Iron, Vitamin B-12.

Question 12

Adolescents are XXX times more likely to get pregnant after WLS?

Answer 12

Two fold increase in pregnancy post WLS

Question 13

What surgery can adolescent’s have for Weight loss?

Answer 13

Yes, RYGB (Gastric Bypass) has been approved
Adjustable bands have NOT been approved
Limited research on Gastric Sleeve in adolescents

YOU need informed consent to have WLS

Question 14

Among patients who had some follow up from bariatric sugary with in ? Months after surgery, receiving complete postoperative follow up was associated with greater comorbidity improvement and remission rates compared to those receiving incomplete follow up.

Answer 14

12 months

Question 15

Adherence with bariatric follow is generally poor.

Answer 15

Results were worse with individuals with lesser weight loss, younger, unemployed or had a lower BMI.

Question 16

Significant weight regain or failure to lose weight should prompt a comprehensive evaluation for?

Answer 16

1. Decreased pt. Adherence w/ lifestyle modification
2. Evaluation of medications associated w/weight gain or impairment of weight loss
3. Development of maladaptive eating disorders
4. Radiographic or endoscopic eval to assess pouch enlargement, anastomotic dilation, formation of gastrogastirc fistula or inadequate band restriction.