Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Apex > Obesity > Flashcards

Obesity Flashcards

1
Q

Each gram of fat produces how many calories?

A

9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where does obesity stand as a leading cause of preventable death?

A

Only second to smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which type of fat accumulation is associated with an increased risk of ischemic heart disease?

A

Android obesity

“Apple shape”
**more common in men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which type of obesity is associated with a pear?

A

Gynecoid

Associated with the development of joint disease and varicose veins
**more common in women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is metabolic syndrome?

A

Several disease states that coincide with obesity

fasting plasma > 110
Abdominal obesity (> 40 in men and > 35 in women)
Serum triglyceride > 150
HLD < 40 in men and < 50 in women
BP > 135/85

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What BMI is considered underweight?

A

< 18.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is considered a normal BMI?

A

18.5-24.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What BMI is considered overweight?

A

25-29

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What BMI is considered obesity class 1?

A

30-35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What BMI is considered obesity class 2?

A

35-40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What obesity is considered obesity class 3?

A

> 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What child body weight class is considered overweight?

A

85th to the 94th

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What child body weight class is considered obese?

A

95-98th

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What child body weight class severely obese?

A

99th

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What body weight describes the BMI associated with the lowest risk of body weight-related comorbidities?

A

Ideal body weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of resp defect does obesity present?

A

Restrictive ventilatory defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is FRC in relation to BMI?

A

Inversely proportional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does obesity affect lung volumes?

A

Decreased vital capacity
Decreased total lung capacity
Decreased FRC
Normal residual volume
Decrease expiratory reserve volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does obesity affect ventilatory defect?

A

Decreased lung compliance > decreased PaO2 (no real change in PaCO2) > increased O2 consumption and increased CO2 production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How does the extra weight on the obese chest affect breathing?

A

Increases WOB > rapid shallow breaths provide the most energy efficient way to achieve this goal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the optimal position for an obese individual during DL?

A

Head elevated laryngoscopy position (HELP)

*should be a horizontal line from the sternal notch to the external auditory meatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does obesity affect circulation?

A

Increased adipocytes ^ vasculature demand ~ necessitates an increased blood volume and cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How much does cardiac output increase per kilogram of fat?

A

100 mL/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How does obesity (an an increased blood volume) affect the heart?

A

Causes diastolic syndication due to increase walk thickness to compensate for increased wall stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How should you calculate perioperative fluid requirements?

A

Based on patients lean body weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Why does obesity stimulate HTN?

A

Hyperinsulinemia
SNS
RAAS activation
Atherosclerosis
Elevated cytokine concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are some EKG associated with obesity?

A

> Low voltage EKG (increased distance from leads)
Left axis deviation (LV hypertrophy)
right axis deviation ( RV hypertrophy)
QT prolongation
ischemia (O2 supply/demand mismatch)
dysrhythmias (fatty infiltration if conduction system)

28
Q

How pharmacodynamic and pharmacokinetic factors change in relation to obesity?

A

Increased volume of distribution for lipophilic drugs
Increased volume of distribution for hydrophilic drugs

**higher cardiac output hastens IV drug delivery to the site of action (shortens circ time)

29
Q

How do you determine lean body weight?

A

IBW x 1.3

30
Q

What type of volatile agents should be used in the obese?

A

Agents with the lowest blood:gas coefficients

Sevo and Des are faster emergence than Iso or propofol

31
Q

How does you dose propofol?

A

LBW: induction
TBW: maintenance

32
Q

How does you dose sux?

A

TBW: ONLY for induction

33
Q

How does you dose roc/vec?

A

LBW: for intubation and maintenance

34
Q

How does you dose cisatracurium/Atracurium?

A

TBW: loading and maintenance

35
Q

How does you dose fent?

A

LBW: maintenance
TBW: loading

36
Q

How does you dose Remi?

A

LBW: both loading and maintenance

37
Q

How does you dose versed?

A

TBW: both loading and maintenance

38
Q

How does you dose local anesthetics?

A

75% of normal dose

39
Q

Which muscle opens the nasopharynx?

A

Tensor palatine

40
Q

Which muscle opens the oropharnx?

A

Genioglossus

41
Q

Which muscle opens the hypopharynx?

A

Hyoid muscles

42
Q

What is OSA defined as?

A

Cessation of airflow for at least 10 seconds with 5 or more unsuccessful efforts to breath (obstruction) and a > 4% reduction in SaO2

43
Q

What is hypopnea defined as?

A

A 50% reduction in airflow for 10 seconds 15 or more times per hour.

44
Q

What factors increase the likelihood of OSA?

A

BMI> 30
Abdominal fat distribution
Large neck girth > 17 inches in men and > 16 inches in women

45
Q

What is OSA an independent risk factor for?

A

HTN, Cardiovascular morbidity , and death

46
Q

What is considered a mild apnea/hypopnea index?

A

5-15 episodes per hr

47
Q

What is considered a moderate apnea/hypopnea index score?

A

15-30 episodes/hr

48
Q

What is considered a severe apnea/hypopnea index?

A

> 30 episodes/hr

49
Q

What is the classic triad of dysfunctional sleep?

A

Apnea o snoring with hypopnea during sleep

Arousal from sleep

Daytime somnolence

50
Q

What is the definite test for OSA?

A

Polysomnography

51
Q

What STOP-BANG score is considered a high risk for OSA?

A

> 3

52
Q

What STOP-BANG score is considered a low risk for OSA?

A

< 3 questions answered yes

53
Q

What is the STOP-BANG score?

A

S: snoring
T: tiredness
O: observes apnea
P: pressure (BP)
B: BMI
A: age (> 50)
N: neck circumference (> 40 cm)
G: gender (male > female)

54
Q

What is obesity Hypoventilation syndrome?

A

Long-term consequence of untreated OSA

“Also called pickwickian syndrome)

55
Q

What is the classic presentation to obesity Hypoventilation syndrome?

A

Apnea during sleep WITHOUT resp effort ~ resp center in medulla fails to respond to hypercarbia

56
Q

What is the diagnostic criteria for obesity Hypoventilation syndrome?

A

BMI> 30
Awake PaCO2 > 45
Dysfunctional breathing during sleep

57
Q

What are some of the signs of obesity Hypoventilation Syndrome?

A

Obesity
Hypersomnolence
Hypoxemia
Hypercarbia
Resp acidosis
Polycythemia
Pulmonary HTN
RV failure

58
Q

What is the MOST sensitive sign of an anastomotic leak following gastric bypass?

A

Unexplained tachycardia

59
Q

What is the most effective treatment for reversing obesity?

A

Bariatric surgery

60
Q

What is a malabsorption approach to surgical weight loss?

A

Examples: jejunoileal bypass, biliopancreatic diversion, duodenal switch
> Points: gastric removal and removal of a portion of the small intestine
> limits nutrient absorption
> patient at risk for Vitamin K, B12, iron, and folate depletion.

61
Q

What is a restriction surgical approach to surgical weight loss?

A

Examples: gastric band, sleeve gastrectomy

> Points: limits quantity of food
least invasive procedure
nutrient absorption is still good
reduced gastric hormone secretion

62
Q

What is a combination surgical approach to surgical weight loss?

A

Examples: Roux-en-Y gastric bypass

> points: combination of malabsorption and restrictive
yields the best weight loss and improvement in comorbidities
risk of nutrient deficiency

63
Q

What are the most common signs of an anastomotic leak?

A

Tachycardia (most)
Fever
Abdominal pain

64
Q

What is the most significant risk factor for the development of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis?

A

Obesity

65
Q

What is Ma Huang?

A

Appetite suppressant

**Natural source of ephedrine
(HTN, CVAs, seizures, adrenergic overstimulation)

66
Q

What is Orlistat?

A

Lipase inhibitor ~ hinders absorption in and digestion of fats.

Fat solublevitamins (DAKE) must be supplemented orally

67
Q

What is sibutramine?

A

Norepinephrine and serotonin inhibitor

used for appetite suppressant
***risk of serotonin syndrome

Apex (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions