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
Non-prescription appetite suppressants that may be a source of drug interactions in the perioperative period include
Ma Huan, phentermine, sibutramine, and orlistat
26
Obesity is the most significant risk factor for the development of
nonalcoholic fatty liver disease and nonalcoholic steatohepatitis
27
Ma Huang is a
natural source of ephedrine, an indirect-acting adrenergic agonist and thermogenic agent
28
Complications of taking Ma Huang include
hypertension adrenergic overstimulation CVAs seizures and death
29
A norepinephrine reuptake inhibitor that acts as an appetite suppressant and increases BMR is
phentermine
30
Complications of taking phentermine include
adrenergic overstimulation
31
A norepinephrine and serotonin reuptake inhibitor that acts as an appetite suppressant and increases BMR is
sibutramine
32
Complications of taking sibutramine are
adrenergic overstimulation serotonin syndrome
33
A lipase inhibitor that reversible binds to lipase and hinders the absorption and digestion of consumed fats is
orlistat
34
Complications of taking orlistat include
impaired vitamins (D, A, K, E) vitamin K impairs synthesis of clotting factors and can cause coagulopathy
35
What clotting factors are impaired with vitamin K impairment?
2, 7, 9, and 10