Obesity Flashcards
How many calories are required to produce one gram of body fat?
a. 4
b. 7
c. 9
d. 11
c. 9
According to the National Institute of health, ______ ranks second to smoking as the leading cause of preventable death.
adult obesity
Childhood obesity is more common than
diabetes
cystic fibrosis
& all cancers
Each gram of carbohydrate and protein provides __ calories of physiologically available energy
4
The etiology of obesity is multifactorial and influenced by
social
pharmacologic
pathophysiologic
genetic factors
Social causes of obesity include
overeating
poor access to proper nutrition
Obesity as a result of medication side effects can be from
steroids
antidepressants
Diseases that can lead to obesity include
Cushing’s disease
hypothyroidism
depression
eating disorders
polycystic ovary syndrome
Genetic disorders that can lead to obesity include
Prader-Willi syndrome
Bardet-Biedl syndrome
Which food corresponds with the MOST pathologic form of fat accumulation?
a. apple
b. carrot
c. pear
d. watermelon
a. apple
Adipose in the body is used as
a readily available energy supply
an insulator
Adipose becomes pathologic when it releases
significant quantities of free fatty acids and cytokines
A terminal consequence of excess adipose tissue is
insulin resistance and inflammation throughout the body
Android obesity is associated with an increased risk of
ischemic heart disease
hypertension
dyslipidemia
insulin resistance
death
Patients with gynecoid fat accumulation are more likely to develop
joint disease
varicose veins
Which type of adipose distribution is more common in men?
android obesity
gynecoid- more common in women
Android obesity is defined as a waist size
> 40 inches for men
35 inches for women
Diagnosis of metabolic syndrome requires at least three of the following signs:
fasting plasma glucose >110 mg/dL
abdominal obesity (>40 in in men and >35 in in women)
serum triglyceride level >150 mg/dL
serum HDL <40 mg/dL in men and <50 mg/dL in women
blood pressure >135/85 mmHg
A patient weighs 176 pounds and stands 74 inches tall. Calculate this patient’s body mass index.
22.59 kg/m^2
BMI is equal to
weight (kg)/ height (m^2)
Overweight is defined as a BMI of
25-29.9
Class 1 obesity is defined as a BMI of
30-34.9
Class 2 obesity is defined as a BMI of
35-39.9
Class 3 obesity is defined as a BMI of
> 40
In children, severely obese is considered to be
weight in the 99th percentile
In children, obese is considered to be
weight in the 95th-98th percentile
In children, overweight is considered to be
weight in the 85th-94th percentile
How do you convert height from inches to centimeters?
1 in= 2.54 cm
Underweight for adults is considered to be
BMI <18.5
Calculate the IBW for a woman who is 5 feet 3 inches tall.
55 kg
How do you calculate IBW for men and women?
men (kg)= height (cm)-100
women (kg)= height (cm)-105
Which factors are reduced by obesity? (select 2)
a. vital capacity
b. expiratory reserve volume
c. closing volume
d. residual volume
a. vital capacity
b. expiratory reserve volume
Obesity produces a ____ ventilatory defect
restrictive
FRC is inversely proportional to
BMI
Patients who are obese have a reduction in FRC that is below
closing capacity causing distal airway collapse during tidal breathing
Patients with obesity have an increased
oxygen consumption and CO2 production
To compensate for obese patient’s increased oxygen consumption,
minute ventilation must be increased
General anesthesia causes FRC to fall by
50%
Patients who are obese have ______________during apnea.
rapid desaturation
An elevated PaCO2 in the obese patient signals
impending respiratory failure
Lung volumes that are decreased in the obese patient include
vital capacity
total lung capacity
functional residual capacity
expiratory reserve volume
What is the optimal tidal volume for a patient with class 3 obesity?
a. 6-8 mL/kg IBW
b. 6-8 mL/kg total body weight
c. 10-12 mL/kg IBW
d. 10-12 mL/kg TBW
a. 6-8 mL/kg IBW
How should obese patients be preoxygenated?
100% FiO2 + CPAP 10 cm H2O until end-tidal O2 >90%
What tidal volume should be used for obese patients?
6-8 mL of IBW
How should you manage PaCO2 for the obese patient?
increase the RR- don’t increase tidal volume
Obese patients are at risk for
post-induction atelectasis
Preventative strategies for post-induction atelectasis include
FiO2 <80%
alveolar recruitment maneuvers
PEEP
Obesity alone does not mandate
RSI
___________ may occur immediately after extubation or up to 2-5 days following surgery
Postoperative hypoxemia
Patients with __________ are at the highest risk of postoperative hypoxemia.
OSA
How should the obese patient be intubated and extubated?
in the reverse Trendelenburg position- relieves pressure on thorax and improves FRC
Strategies to maximize postoperative oxygenation include:
CPAP or BiPAP after extubation
elevate the head of the bed to 30 degrees
early ambulation
control surgical pain- non-opioid analgesics and regional anesthesia will minimize respiratory depression
incentive spirometry
