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Apex Review > Obesity 3 > Flashcards

Obesity 3 Flashcards

1
Q

Obesity hypoventilation syndrome is a long-term consequence of

A

untreated OSA

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2
Q

The classic presentation of obesity hypoventilation syndrome includes

A

episodes of apnea during sleep WITHOUT any respiratory effort

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3
Q

Diagnostic criteria for obesity hypoventilation syndrome is

A

BMI >30 kg/m2
awake PaCO2 >45 mmHg
dysfunctional breathing during sleep

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4
Q

Signs of obesity hypoventilation syndrome include

A

obesity, hypersomnolence during the day, respiratory acidosis, compensatory metabolic alkalosis, polycythemia, pHTN, and right heart failure, hypoxemia, and hypercarbia

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5
Q

_________________ puts patients with obesity hypoventilation syndrome at high risk of airway obstruction and respiratory arrest.

A

The administration of any respiratory depressant drug

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6
Q

_________ is the old school name for obesity hypoventilation syndrome

A

Pickwickian syndrome

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7
Q

With obesity hypoventilation syndrome, over time, the respiratory center in the medulla

A

fails to respond to hypercarbia appropriately

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8
Q

Medications that could be considered for patients with obesity hypoventilation syndrome include

A

regional anesthesia, NSAIDs, acetaminophen, ketamine, dexmedetomidine

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9
Q

What is the MOST sensitive sign of an anastomotic leak following gastric bypass?
a. shoulder pain
b. unexplained tachycardia
c. abdominal pain
d. fever

A

b. unexplained tachycardia

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10
Q

_________ is the most effective treatment for reversing obesity.

A

Bariatric surgery

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11
Q

Bariatric surgery usually leads to the resolution of

A

comorbidities such as hypertension and type 2 diabetes

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12
Q

The three approaches to surgical weight loss include:

A

malabsorption
restriction
combination

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13
Q

Examples of malabsorption surgeries include

A

jejunoileal bypass
bileopancreatic diversion
duodenal switch

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14
Q

Examples of restrictive surgeries include

A

gastric band
sleeve gastrectomy

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15
Q

Examples of combination surgeries include

A

Roux-en-Y gastric bypass

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16
Q

What type of surgical approach for bariatric procedures yields the best weight loss and improvement of comorbidities?

A

Roux-en-Y gastric bypass

17
Q

__________ is the most sensitive sign of an anastomotic leak

A

Unexplained tachycardia

18
Q

Other common s/sx of anastomotic leak include

A

fever & abdominal pain

19
Q

The risk associated with combination surgery include

A

risk of nutritional deficiency

20
Q

The risk of malabsorption surgery includes

A

risk of Vit K, Vit B12, iron, and folate depletion

21
Q

What type of procedure results in reduced gastric hormone secretion?

A

restriction

22
Q

Additional signs and symptoms of an anastomotic leak include

A

shoulder pain (usually left)
pelvic pain
substernal pressure
dyspnea
hypotension
oliguria
increased thirst
restlessness
hiccups

23
Q

There is no data that illustrate _________ on the basis of BMI alone

A

an increased risk of pulmonary aspiration

24
Q

Obese patients with other risk factors such as GERD or diabetes should be considered

A

candidates for aspiration prophylaxis and RSI

25
Q

Non-prescription appetite suppressants that may be a source of drug interactions in the perioperative period include

A

Ma Huan, phentermine, sibutramine, and orlistat

26
Q

Obesity is the most significant risk factor for the development of

A

nonalcoholic fatty liver disease and nonalcoholic steatohepatitis

27
Q

Ma Huang is a

A

natural source of ephedrine, an indirect-acting adrenergic agonist and thermogenic agent

28
Q

Complications of taking Ma Huang include

A

hypertension
adrenergic overstimulation
CVAs
seizures and death

29
Q

A norepinephrine reuptake inhibitor that acts as an appetite suppressant and increases BMR is

A

phentermine

30
Q

Complications of taking phentermine include

A

adrenergic overstimulation

31
Q

A norepinephrine and serotonin reuptake inhibitor that acts as an appetite suppressant and increases BMR is

A

sibutramine

32
Q

Complications of taking sibutramine are

A

adrenergic overstimulation
serotonin syndrome

33
Q

A lipase inhibitor that reversible binds to lipase and hinders the absorption and digestion of consumed fats is

A

orlistat

34
Q

Complications of taking orlistat include

A

impaired vitamins (D, A, K, E)
vitamin K impairs synthesis of clotting factors and can cause coagulopathy

35
Q

What clotting factors are impaired with vitamin K impairment?

A

2, 7, 9, and 10

Apex Review (224 decks)

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