Harman hints test #1 fat asses

Question 1

BMI formula

Answer 1

weight (in kg) / height (in meters)^2
or
weight (lbs) / Height (inches^2) x 703

Question 2

side note how many inches in 1 meter (for BMI conversion)

Answer 2

0.0254

Question 3

Calculate BMI using either or both formulas for 6’9” man who weight 300lbs (round it off JAKE)

Answer 3

300lbs=136kg
6'9"= 81 inches (6,561 inches^2)
81 inches= 2.0574 meters (4.2 meters ^2)
ok so....
136kg/4.2m^2=32.3 kg/m^2 
or 300lbs / 6,562 inches^2 x 703 = 32.1

Question 4

BMI ranges
under weight
Normal
overweight
obese I
obese II
extremly obese III
superobese
super-super obese

Answer 4

under weight- < 18.5
Normal- 18.5-24.9
overweight- 25-29.9
obese I- 30-34.9
obese II- 35-39.9
extremly obese III- > 40
superobese- >50
super-super obese- > 60

Question 5

IBW formulas

Answer 5

MEN:
height (cm) - 100
WOMEN:
Height (cm) - 105

Question 6

side note how many cm in an inch

Answer 6

2. 54cm

* **(so for IBW use 2.54 conversion for inches to cm and for BMI use 0.0254 for inches to meters)

Question 7

calculate IBW
MAN- 18’9”
WOMAN- 5’8”

Answer 7

man
18'9"= 225inches=571.5 cm
so 571.5-100= 471 kg
woman
5'8"=68 inches=172.72cm
so 172.72cm-105=67.72kg

Question 8

how is IBW recorded

Answer 8

Kg

Question 9

what % of U.S. adults are overweight or obese

Answer 9

65%

Question 10

what % of U.S. adults are obese

Answer 10

30%

Question 11

re-read N&P pg 1036 aspiration prophylaxis and consider inLMA is ALWAYS contraindicatedbin obese pt?

Answer 11

-it is known GERD and hiatal hernia are more prevalent in the obese, and this may predispose them to esophagitis and pulmonaryaspiration
- More recent data, howver, have demonstrated that obese pts (BMI > 30) may have lower incidence of “at rrisk” stomach contents compared to lean pts
-in one study researchers evaluated gastric contents of 232 surgical pts. only 20 of 75 (27%) had high, volume, low PH stomach contnets, compared to 66 of 157 (42%) of lean pts
-more recent studies have also demonstrated that obese pt’s who are fasting may not have gastric PH and volumes that would put them at risk for Pulmonary aspiration.
-there is no concensus on wheter obese pts have delayed, normal, or accelerated gastric emptying
-obesity is significantly r/t GERD
-More recent and favorable data, some advocate the ovoidance of RSI on obese pt’s as standard of care
SO I WOULD SAY NO

Question 12

indications for bariatric sx

Answer 12

u have dieted and failed

• BMI > 40
• BMI >35 and have serious health conditions associated with your obesity (DM, HTN, Depression, heart disease, OSA)
• more than 100lbs over IBW

Question 13

3 types of bariatric sx’s

Answer 13

restricive
combined restrictive and malabsorptive
malabsorptive

Question 14

3 types of restrictive procedures

Answer 14

LAP band
Sleeve gastrectomy
Verticle banded gastroplasty

Question 15

1 ex of combined restrictive and malabsorptive procedures

Answer 15

Roux-en-Y gastric bypass

Question 16

1 ex of malabsorptive procedure

Answer 16

biliopancreatic Diverson with duodenal switch

Question 17

Long term risk of gastric bypass

Answer 17

weight regain
anemia
vit/min deficiency
ETOH use d/o

Question 18

short term risk of gastric bypass

Answer 18

Hair loss
Kidney stones
N/V
Gallstones
hernia/ SBO/LBO
periphreal neuropathy

Question 19

Complications with bariatric sx

Answer 19

dumping syndrome
cholelithiasis
PE/DVT
anastomotic leak
GJ stricture

Question 20

Complications unique to AGB procedure

Answer 20

port disconnection/rupture
port displacement with stomach slippage
band rupture/erosion
port blockage/infection
tube related malfunction

Question 21

Benefits of gastric sx

Answer 21

reversing metabolic syndrome
decreased bp
decreased trig;ycerides
improves OSA/OHS
improves 
    -Nonalcoholic liver disease
    -GERD
    -Incontinence
    -polycystic ovarian syndrome
    -venous stasis
    -DJD
cure DM
Improves endocrine system

Question 22

Unique thing about gastric sx and DM

Answer 22

it can actually improve or cure DM even B4 weight loss

Question 23

expected weight loss of sx (of excess body weight only)

Answer 23

AGB-25-80%
Sleeve- 65-75%
Rouex-en-Y 50-70%