deck 5

Question 1

problem with Roux-en-Y gastric bypass

Answer 1

complications common, occurring with about 40% of cases.

Question 2

indications for bariatric surgery

Answer 2

BMI greater than 40 or 35 if obesity-related comorbidities present

Question 3

OCPs and osteoporosis?

Answer 3

no evidence that use increases risk

Question 4

common cause of accelerated bone loss..

Answer 4

hyperthyroidism

Question 5

interpreting DEXA scans

Answer 5

T-score (the number of standard deviations above or below the mean matched to YOUNG controls) and a Z-score (the number of standard deviations above or below the mean-matched to age-matched controls). Z-scores are of little value to clinicians. A T-score more than 2.5 standard deviations below the mean (a score of —2.5 or lower) indicates osteoporosis.

Question 6

osteoporosis drug with analgesic qualities

Answer 6

calcitonin

Question 7

other distinguishing feature between AN and bulimia

Answer 7

bulimics sense a lack of control over eating during episodes of binging, while anorexics often feel a strong sense of control. This is a characteristic that may help distinguish the two.

Question 8

labs to order when working up ADHD

Answer 8

Blood chemistries, a thyroid stimulating hormone, and a lead level.

Question 9

substance abuse risk with stimulants for ADHD kids?

Answer 9

There is a decreased risk of substance abuse in adolescents treated for ADHD

Question 10

hashimoto’s presentation

Answer 10

• enlarged thyroid that is tender in middle aged woman.

Question 11

most common symptom of hyperthyroidism

Answer 11

fatigue

Question 12

subclinical hypothyroidism

Answer 12

elevated TSH + normal free T4

Question 13

management of subclinical hypothyroidism

Answer 13

monitor at yearly intervals

Question 14

primary hypothyroidism lab profile

Answer 14

TSH elevated, free T3/T4 low

Question 15

isolated systolic hypertension

Answer 15

systolic elevated, diastolic normal

Question 16

stage 1 HTN

Answer 16

140-159, or 90-99

Question 17

stage 2 HTN

Answer 17

greater than 160, or greater than 100

Question 18

hypertensive urgency vs. emergency

Answer 18

both greater than 180/20, emergency indicates end-organ damage

Question 19

when to treat HTN

Answer 19

systolic greater than 140 or diastolic greater than 90

Question 20

for AA’s initial therapy for HTN should be…

Answer 20

thiazide or CCB

Question 21

HTN drug of choice for patients with CKD and elevated creatinine

Answer 21

loop diuretics

Question 22

combined therapy for ACEI and ARB?

Answer 22

• increased adverse effects and no improvement in outcome.

Question 23

HTN drug for patients with CAD

Answer 23

b-blockers (decrease cardiovascular mortality)

Question 24

HTN drug for patients with asymptomatic ventricular dysfunction and HF

Answer 24

ACEiI’s

Question 25

HTN drug for patients with CVA

Answer 25

ACEI + thiazide diuretic

Question 26

diuretics contraindications

Answer 26

gout

Question 27

drug for systolic HTN

Answer 27

diuretics

Question 28

b-blocker contraindications

Answer 28

asthma, COPD, heart block

Question 29

ACEI’s indications

Answer 29

HF, LV dysfunction, post-MI

Question 30

testing for all patients with BMI greater than 25

Answer 30

1) fasting blood glucose or hba1c,
2) creatinine
3) fasting lipid panel

Question 31

reasonable weight loss goal per week

Answer 31

0.5-1.0 lb per week

Question 32

when drug therapy is indicated for obesity

Answer 32

• BMI greater than 30.0

- BMI greater than 27.0 + comorbidities

Question 33

problem with orlistat

Answer 33

hepatotoxic

Question 34

complications of bariatric surgery

Answer 34

severe GERD, N/v< band erosion, stomal obstruction

Question 35

how to prevent diabetes?

Answer 35

• meds are effective in pre-diabetic patients but less so than lifestyle modification

Question 36

when to screen for diabetes?

Answer 36

1) USPSTF –> asymptomatic adults with sustained BP greater than 135/80
2) ADA –> patients overweight + risk factors (HTN, dyslipidemia, triglyceridemia, PCOS, first degree relatives with diabetes).

Question 37

labs to order once diabetes is diagnosed

Answer 37

Screen for complications with fasting lipid profile, serum electrolyte panel, UA, ECG

Question 38

microvascular complications of T2DM

Answer 38

retinopathy, nephropathy, neuropathy

Question 39

target hba1c for patients with history of hypoglycemia, advanced microvascular complications, or limited life expectancy

Answer 39

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