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Block 3, week 4 Dani > Dr. Sasse > Flashcards

Dr. Sasse Flashcards

1
Q

(Blank) causes diabetes, causes poor health, reduces quality of life.

A

obesity

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2
Q

Solutions to obesity is to change the (blank)

A

physiologic set point

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3
Q

Type 2 diabetes accounts for over (blank) percent of diabetic patients.

A

98%

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4
Q

Obesity epidemic began (blank) years ago.

A

40

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5
Q

Wheat today has higher (blank) than table sugar

A

higher glycemic index

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6
Q

The food supply today is ….

A 
sweeter
whiter
less green
less purple
less bitter
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7
Q

Have genes changed?

A

yes, just not yours. Genes in the food have changed

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8
Q

What are these:
Type II diabetes
cardiovascular disease
breast and colon cancer

A

Comorbidities of obesity

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9
Q

What are the environmental drivers to obesity?

A

altered food supply** (test question answer)
decreased physical activity
stress and distress
drugs (accounts of to 10%)

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10
Q

When you have diabetes, what drug causes weight gain?

A

insulin

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11
Q

What is the number one cause of kidney failure, blindness, neuropathy, amputation, small vessel disease?

A

diabetes :(

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12
Q

What is the definition of diabetes and how many people have it?

A

HgB A1c> 6.5.% or FBS>125

26 million

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13
Q

What is the definition of pre-diabetes and how many people have it?

A

HgbA1c 6.0-6.5% or FBS 100-125)
79 million
(33%of these develop diabetes within 3 years)

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14
Q

How does HgbA1C work to test glucose levels?

A

When you have high glucose around this causes the glycation of hemoglobin and the amount of glycated hemoglobin will tell you your blood sugar levels

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15
Q

What are these:

higher risk of MI, hypertension, CO2 retention and resp failure, gait instabiity, endocrine problems such as diabetes.

A

things to worry about with obese patients prior to surgery.

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16
Q

What are concerning signs of obese patients?

A

tachycardia may indicate sepsis and ab exam is unreliable
Delerium
immobility

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17
Q

What wounds can often occur through fat rolls of obese patients?

A

sacral decubitus wounds

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18
Q

What is the set point?

A

the point where your weight typically is at. (makes it tough to lose weight)

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19
Q

Non surgical weight loss typically results in indiviudals able to maintain there weight loss. T OR F?

A

False, they lose it short term but then go back to set point.

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20
Q

Surgical weight loss is effective for maintenance of weight loss. T or F?

A

True

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21
Q

What makes your set point?

A 
When you burn calories
hormonal changes (increase appetite)
metabolic rates (decreased metabolic rates)
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22
Q

(blank) is the hormone of hunger

A

ghrelin

23
Q

(blank) plays a role in glycemic regulation by slowing gastric emptying and promoting satiety, thereby preventing post-prandial spikes in blood glucose levels.

A

Amylin

24
Q

(blank) is the hormone of satiety

A

CCK

25
Q

Since are body is against us losing weight, when we go on a diet what happens to CCK and grehelin

A

CCK goes down and ghrelin goes up

26
Q

Your metabolic burn rate will (BlanK) when you diet.

A

decrease

27
Q

The defense of the set point is when you are on a diet and exercising:
Your CCK decreases (being satisified) your grehelin increase (being hungry) and your metabolic rate decreases. This all sucks however there is a glimmer of hope, what is this?

A

that you can decrease the strength of these defending effects over time

28
Q

Who invented the BMI?

A

the insurance industry

29
Q

Tell me about the treatment pyramid

A

surgery (top)-> medications (middle)-> diet and physical activity (base)

30
Q

At what BMI, does a surgical intervention help with obesity?

A

27

31
Q

What is fenfen (fenfluarime)?

A

5HT 2b receptor that was used as a diet pill and killed people via cardiac valvuopathy so off market

32
Q

What is sibutramine?

A

works on 5HT, was used as a diet pill and caused CV disease so off market

33
Q

What is Orlistat (xenical)?

A

it makes you poop out fat (inhibits lipase)

-not very effective

34
Q

What is phentermine?

A

it is a caffeine mild stimulant (effective)

35
Q

What are the 2 new prescription drugs used to treat obesity (within the last 2 years)?

A

qsymia

Belviq

36
Q

What is this:

combination of phentermine and topiramate ER which results in improved glucose and Trig for upper dose.

A

qsymia

37
Q

What is this:

Lorcaserin, results in loss of body weight

A

belviq

38
Q

What is this for:

Counseling, diet and exercise, support groups, structured programs, supplemets, meds and surgeries.

A

Integrated Approach to Obesity and Type 2 Diabetes

39
Q

Who qualifies for weight loss surgery?

A

BMI 30 or greater AND
one of the following high cholesterol
sleep apnea
diabetes

40
Q

What surgery is FDA regulated

A

Lat band surgery

41
Q

What are the three approved weight loss surgeries?
How long are these surgeries?
What are the risks?

A 
gastric banding,
vertical sleeve gastrectomy
roux-en-Y gastric bypass
About 50 minutes (they gotta stay 23 hours after though)
same risks as C-section
42
Q

What is the durability of the procedures?

A

80% at 10 years

43
Q

What is the vertical sleeve gastrectomy?

A

restrictive and hormonal procedure which creates a small more slender stomach by removing 80% of the stomach. You remove part of the mucosa that blunts the affect of making you feel hungry.

44
Q

What does the sleeve do to a person’s physiology?

A

changes the physiologic set point

increase met rate and decreases hunger

45
Q

Why the sleeve over the gastric bypass?

A

it is less invasive, simpler, safer, insurance covered

46
Q

Does the sleeve work? does the bypass work?

A

yup and yup

47
Q

(blank) improvement is dependent on weight loss

A

diabetes

48
Q

People that were able to stop taking medications to control their diabetes used …..

A

gastric bypass and the sleeve

diet and exercise didnt cut it

49
Q

Surgical patients had (blank) times lower mortality rate within the study period.

A

nine

50
Q

HOw to change the physiologic set point?

A

surgery, definitely
persistance for a year, possibly
walking 60-90 minutes per day, probably

51
Q

What is the number one cause of liver transplants and cirrhosis?

A

obesity!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

52
Q

Is complete remission possible for diabetes?

A

yes, especially with surgery

53
Q

What are the three vitamin deficiencies that can result from gastric surgery?

A

iron,
vitamin B12
vitamin D

Block 3, week 4 Dani (10 decks)

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