Midterm Review Flashcards
What are (2) formulas that can be used to calculate BMI?
BMI = weight (kg) / height (m^2)
BMI = [weight (lbs) / height (in^2)] x 703
BMI class (ASA)–overweight = ___-___
25-29.9
BMI class (ASA)–obese class I = ___-___
30-34.9
BMI class (ASA)–obese class II = ___-___
35-39.9
BMI class (ASA)–obese class III/extreme obese = ___-___
40-44.9
BMI class (ASA)–obese class IV/severe obesity = > ___
> 45
What type of fat distribution is central or abdominal visceral; patients are apple shaped?
Android
What type of fat distribution is gluteal, femoral, or peripheral; patients are pear shaped?
Gynecoid
Which type of obesity (android or gynecoid) is associated with more comorbidities?
Android
Increased cardiac output of ___ L/min for each kg of fat
Increased CO of 0.1 L/min for each kg of fat
Respiratory–obese patients have ___ (increased/decreased) lung compliance; why?
Obese patients have DECREASED lung compliance; d/t pressure from abdominal, diaphragmatic, and thoracic fat
Obese patients have a ___ F/V loop pattern
Obese patients have a RESTRICTIVE F/V loop pattern
Obese patients have ___ (increased/decreased) FRC, ERV, VC, TLC; ___ (increased/decreased) dead space; ___ (increased/decreased/no change) in RV, CC, FVC, and FEV1
Obese patients have DECREASED FRC, ERV, VC, TLC; increased dead space; no change in RV, CC, FVC, and FEV1
Obese patients ___ventilate, which leads to ___carbia and ___osis
Obese patients HYPOventilate, which leads to HYPERcarbia and acidosis
What volumes/capacities are decreased in obese patients?
Decreased
- FRC
- VC
- TLC
- ERV
What volumes/capacities show no change in obese patients?
No change
- RV
- CC
- FVC
- FEV1
What is OSA defined as?
Excessive episodes of apnea (10 seconds) and hypopnea
OSA includes > ___ episodes of apnea per hour or ___ per night
OSA includes > 5 episodes of apnea per hour or 30 per night
OSA leads to ___ia, ___carbia, ___ and ___ hypertension, and cardiac ___
OSA leads to hypoxia, hypercarbia, systemic and pulmonary hypertension, and cardiac arrhythmias
What is the gold standard test for OSA?
Polysomnography (PSG)
What questionnaire can we use to evaluate patients for OSA and has up to 93% sensitivity?
STOP-BANG
What does STOP-BANG stand for?
S-Snoring (Do you snore loudly?)
T-Tiredness (Do you often feel tired, fatigued, or sleepy during the daytime?)
O-Observed apnea (Has anyone observed that you stop breathing, or choke or gasp during your sleep?)
P-high blood Pressure (Do you have or are you being treated for high blood pressure?)
B-BMI (Is your body mass index more than 35 kg per m^2?)
A-Age (Are you older than 50 years?)
N-Neck circumference (Is your neck circumference greater than 40 cm [15.75 inches]?)
G-Gender (Are you male?)
What syndrome does this describe?–inappropriate and sudden somnolence, OSA, hypoxia, hypercapnia, arterial hypoxemia, cyanosis-induced polycythemia, respiratory acidosis, pulmonary hypertension, right sided heart failure
Obese hypoventilation (Pickwickian) syndrome
Obese hypoventilation (Pickwickian) syndrome can lead to what? How?
Right heart failure d/t hypoxic pulmonary vasoconstriction (AKA cor pulmonate)