Obesity Flashcards
These are defined as foreign chemicals hypothesized to disrupt normal development and balance of lipid metabolism which can lead to obesity.
obesogens
What are the 4 regulators of hunger?
- brain
- gut
- adipose tissue
- pancreas
How do you calculate the excess BW?
current weight - IBW (weight if BMI were 25)
What is the best documented risk factor for obstructive sleep apnea?
obesity
A female patient presents with hirsutism, acne, obesity, and fatigue. She has had a difficult time getting pregnant. What is the diagnosis?
PCOS
How is metabolic syndrome defined?
3+ of the following
- central obesity
- elevated glucose
- elevating fasting triglycerides
- low blood HDL
- HTN
At a BMI of 25-30 what is the best treatment option?
a. surgery
b. pharmacotherapy
c. lifestyle modifications
c. lifestyle modifications
At a BMI of 27+ with comorbidities or a BMI of 30-35 what is the best treatment option?
a. surgery
b. pharmacotherapy
c. lifestyle modifications
b. pharmacotherapy
At a BMI of 35+ with comorbidities or a BMI of 40+ what is the best treatment option.
a. surgery
b. pharmacotherapy
c. lifestyle modifications
a. surgery
Which of the following interventions will result in the greatest estimated excess body weight loss?
a. lifestyle/pharmacologic
b. laparoscopic adjustable banding
c. sleeve gastrectomy
d. gastric bypass
d. gastric bypass
- lifestyle/pharmacologic = 10-20%
- laparoscopic adjustable banding = 40%
- sleeve gastrectomy = 50-60%
- gastric bypass = 65-70%
What medication can be used for hunger/appetite control?
- phentermine
Any patient on an antipsychotic should be on this diabetes medication.
- metformin
These 8 criteria must be met to be a surgical candidate.
- BMI >40 or >35 with comorbidity
- age 18+
- failed prior weight loss attempt
- patient understands surgery/risks
- acceptable operative risks
- stable psychosocial condition
- no nicotine/THC use
- minimal alcohol use
Bariatric surgery decreases the risk of death over 5 years by what %?
89%
What is the incidence of mortality with bariatric surgery?
0.13%
What are the 2 non narcotic analgesia medication commonly prescribed post-op?
- IV tylenol
- IV ketorolac
What are the 5 phases of post-bariatric diet progression?
- 1 = clear liquids
- 2 = full liquids
- 3 = pureed foods
- 4 = ground
- 5 = healthy bariatric diet
What are the 3 items that should be a part of all post-bariatric diet phases?
- protein
- vitamins
- fluids
What is the cause of weight regain after surgery?
multifactorial
- adhere to weight loss program, lack of exercise, poor eating habits
Acanthosis nigricans and acrochordons are findings consistent with what diagnosis?
- insulin resistance/diabetes
What is the number 1 late complication of gastric bypass?
- anastamotic ulcer
A patient presents with bilious vomiting following a gastric bypass. On CT you see a mesenteric swirl sign. What is the diagnosis?
- internal hernia
MUST call a surgeon
A patient presents with vague abdominal discomfort and intractable nausea following a gastric bypass 5 days ago. What is the diagnosis?
- portal venous thrombosis
What are the 5 medical conditions that can occur after bariatric surgery?
- cholecystitis
- choledocholithiasis
- gallstone pancreatitis
- abdominal wall hernia
- SBO
