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C. Year 3 MLA Reproductive and Endocrinology > Obesity > Flashcards

Obesity Flashcards

1
Q

The definition of obesity according to WHO is an excess in body fat that can subsequently cause adverse health. What BMI is classed as overweight?

1 - <18.5kg/m2
2 - >25kg/m2
3 - <30kg/m2
4 - <35kg/m2

A

2 - >25kg/m2

  • obese is >30kg/m2
  • formula for BMI = weight (kg)/height (m)2
  • 80kg / 1.9 squared = BMI of 22.16
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2
Q

Is waist circumference a measure of central (fat around belly) or general obesity (fat everywhere)?

A
  • central obesity
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3
Q

What is central and general obesity?

A
  • central = fat is centred around chest and abdomen
  • general = fat is everywhere
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4
Q

Is it important to use age and gender specific standards and centrile charts?

A
  • yes
  • age and gender both influence body composition
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5
Q

Do patients with a low income consume more or less fruit and vegetables than those with a higher incomes, and total calories?

A
  • low income less fruit and vegetables
  • BUT more total calories as processed food is cheap
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6
Q

Do patients who are well educated have higher energy expenditure than those who are less well educated?

A
  • educated and energy expenditure are inversely associated
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7
Q

Do obese patients tend to marry earlier or later, and marry obese or non obese people than those who are not obese?

A
  • obese people marry later
  • obese are more likely to marry obese partners
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8
Q

Do married or single men weight more?

A
  • married men weigh more than single men
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9
Q

If women have more than one child, do they generally return to their previous weight, or do they generally gain weight with each baby?

A
  • weight increases with each child
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10
Q

Are older people who live alone more likely to be underweight than older people living with someone?

A
  • older people who live alone are more likely to be underweight
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11
Q

In 2016, according to the WHO what % of the worlds population that were >18 years of age at the time were classed as being obese and overweight?

1 - 39% and 13%, respectively
2 - 13% and 13%, respectively
3 - 13% and 39%, respectively
4 - 3% and 1%, respectively

A

1 - 39% and 13%, respectively
- 39% were overweight
- 13% were obese.

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12
Q

What is the name of the obesity scoring system?

1 - Wells score
2 - Edmonton Obesity Staging System (EOSS)
3 - Obesity associated morbidity score (OAMS)
4 - Disease associated obesity score (DAOS)

A

2 - Edmonton Obesity Staging System (EOSS)
- scored from 0-4 on how obese and health implications

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13
Q

Which of the following does NOT typically lead to weight gain?

1 - low thyroid hormone
2 - increased testosterone
3 - reduced cortisol
4 - low levels of leptin
5 - all of the above

A

3 - reduced cortisol
- elevated cortisol increases appetite

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14
Q

Which of the following conditions has NOT typically been linked with obesity?

1 - Hyperthyroidism
2 - Cushing’s disease/syndrome (high secretion of adrenocorticotropic)
3 - Hypothalamic lesions
4 - Polycystic ovary syndrome (PCOS)
5 - Iatrogenic: drugs, e.g. antipsychotic medication, glucose-lowering medication (sulfonylureas and insulin), GCs. recreational drugs, e.g. cannabis.

A

1 - Hyperthyroidism
- this would cause weight loss
- hypothyroidism is linked to weight gain

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15
Q

In the majority of the world, is being overweight or underweight associated with higher mortality rates?

A
  • overweight
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16
Q

is obesity and overweight only a problem in high income countries?

A
  • no it is now present in middle and low income countries
17
Q

In England between 2017 and 2018, what % of year 6 school children were classified as obese?

1 - 2%
2 - 12%
3 - 20%
4 - 40%

A

3 - 20%

18
Q

At what age in men and women does obesity peak in England according to NHS stats?

1 - M = 55-64 and F = 65-74 y/o
2 - M = 65-74 and F = 55-64 y/o
3 - M and F = 55-64
4 - M and F = 55-64

A

1 - M = 55-64 and F = 65-74 y/o
- men = 55-64 years old
- women = 65-74 years old
- obesity generally increases with age

19
Q

How does obesity affect cellular and metabolic mechanisms?

1 - increases insulin resistance
2 - impairs pancreatic function
3 - increases hepatic glucose output
4 - increases circulating fatty acids
5 - all of the above

A

5 - all of the above
- increased fat in organs impairs function and increases insulin resistance
- essentially obesity impairs metabolic function

20
Q

Does obesity affect joints?

A
  • yes
  • increased weight increases wear and tear
  • increased risk of osteoarthritis
21
Q

Does obesity affect the airways?

A
  • yes
  • can cause a restrictive lung disease
  • increases fat around airways
  • increases risk of asthma and sleep apnoea
22
Q

What is one of the most common diseases that is associated with central obesity?

1 - T2DM
2 - Ischaemic heart disease
3 - NAFLD
4 - CKD

A

1 - T2DM
- always test patients who are obese for diabetes

23
Q

The NICE guidelines have identified how to assess and identify and manage patients with obesity based on their risk factors that encompass BMI, wasit circumference and co-morbidities. What are the 4 levels of the intervention plan?

A
  • level 1 = general advice healthy weight and lifestyle
  • level 2 = diet and physical health
  • level 3 = diet and physical activity, drugs
  • level 4 = diet and physical activity, drugs, surgery
24
Q

When discussing diets with patients they should be tailored to the individual. Typically patients basal metabolic rate should be calculated and then what number of calories should be subtracted from this?

1 - 250
2 - 600
3 - 1000
4 - 2000

A

2 - 600
- this is kcals and should be the aim for each day

25
Q

In patients who are very overweight the weight loss should be specific to them. What is the target weight loss for patients?

1 - 1-2% overall weight
2 - 5-10% overall weight
3 - 10-30% overall weight
4 - >50% overall weight

A

2 - 5-10% overall weight
- 0.5-1kg/week
- 5% weight loss improves health outcomes

26
Q

Bariatric surgery is a procedure aimed at facilitating weight loss through reducing the size of the stomach so patients are unable to eat as much. Typically, what BMI do patients need to have before they will be considered for bariatric surgery?

1 - >30kg/m2
2 - >35kg/m2
3 - >40kg/m2
4 - >50kg/m2

A

3 - >40kg/m2
- if the patient has other comorbidities than a BMI of 35-40kg/m2 should be considered

27
Q

The guidelines for weight loss surgery are:

  • BMI >40kg/m2
  • BMI between 35 and 39.9kg/m2 with severe obesity‐related comorbidity (T2DM)
  • BMI between 30 and 34.9kg/m2 and poorly controlled diabetes

In addition, there is one group of patients where the BMI is lowered by 2.5. Which group of patients is this?

1 - >65 y/o
2 - <18 y/o
3 - asians
4 - jewish

A

3 - asians
- increased risk of diabetes and comorbidities

28
Q

Following weight loss surgery there are multiple mechanisms of how weight loss is achieved. All of the following have been identified, EXCEPT which one?

1 - Increases in satiety-promoting hormones
2 - Reductions in hunger-promoting hormones
3 - Reduced food intake
4 - Central effects
5 - Altered bile acid metabolism
6 - Altered intestinal microbiota
7 - Dumping syndrome

A

7 - Dumping syndrome
- this an adverse event of surgery

29
Q

In patients who have a BMI >30 or >27kg/m2 with comorbidities may be offered anti-obesity agents. One of these drugs is Orlistat, but what is the mechanism of action of Orlistat?

1 - inhibits appetite centre
2 - inhibits pancreatic lipase
3 - appetite suppression
4 - all of the above

A

2 - inhibits pancreatic lipase
- causes fatty stools and diarrhoea
- contraindicated in cholestasis, hepatic dysfunction, malabsorption, pregnancy, breastfeeding, renal impairment

30
Q

In patients who have a BMI >30 or >27kg/m2 with comorbidities may be offered anti-obesity agents. One of these drugs is GLP-1 agonists, Liraglutide or Semaglutide. How does GLP-1 induce weight loss?

1 - inhibits appetite centre
2 - inhibits pancreatic lipase
3 - appetite suppression
4 - all of the above

A

3 - appetite suppression
- causes nausea and vomiting, Gallstone, pancreatitis

31
Q

In patients who have a BMI >30 or >27kg/m2 with comorbidities may be offered anti-obesity agents. One of these drugs is Naltrexone with bupropion. How do these 2 drugs induce weight loss?

1 - inhibits appetite centre
2 - inhibits pancreatic lipase
3 - appetite suppression
4 - all of the above

A

3 - appetite suppression

C. Year 3 MLA Reproductive and Endocrinology (22 decks)

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