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Intro to Clinical Medicine > Obesity > Flashcards

Obesity Flashcards

1
Q

What percent of Americans are obese?

A

35%

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2
Q

what percent of Americans are overweight on top of that?

A

30%

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3
Q

Whats a classic syndrome that causes obesity and what are its symptoms?4

A

Prader-Willi—

almond eyes, decreased muscle tone, hypogonadism, truncal obesity

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4
Q

What percent of people actually have an underlying disease causing obesity?

A

less than 1%

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5
Q

Secondary causes of obesity (besides environmental)

5

A
  1. Cushing’s Syndrome—purple striae, thinning skin, easy bruising, proximal muscle weakness
  2. Insulinoma
  3. Hypothyroidism
  4. Hypothalamic damage resulting in hyperphagia
  5. Growth hormone deficiency
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6
Q

What increases the rate of death from all causes but especially CVD?

A

the higher the BMI the higher the risk

but also low BMI is associated with mortality

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7
Q

Describe the framingham study?

Obese at age 40?

Overweight at age 40?

Overweight and smoked at age 40?

A

Those who were obese at age 40 lived 6-7 years less than those who were not obese

Those who were overweight (BMI 25-29.9) lived about 3 years less

Those who were overweight & smoked lived 13-14 yrs. less

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8
Q

Obesity causes 80% of cases of what disease?

A

Type II Diabetes Mellitus

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9
Q

What does weight gain lead to in prediabetic patients?

A

impairment of glucose removal and increased insulin resistance

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10
Q

Hypertension is greatest in those with what kind of obesity?

A

upper body and abdominal obesity

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11
Q

What does hyperinsulinemia cause?

3

A
  1. increase sympathetic activity, 2. renal Na+ retention and
  2. possibly increase vascular tone
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12
Q

How many kg of weight lost does it take for BP to fall 1mm/Hg?

A

1

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13
Q

Obesity can cause dyslipidemia. What is affected?

2

A

Dyslipidemia:

  1. Affects all lipid values and
  2. can reduce HDL which is most concerning (central fat distribution is one cause)
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14
Q

Obesity can cause heart disease. What is affected?

A
  1. increased CHD and CV mortality (usually from DM, dyslipidemia, HTN)
  2. Heart failure (more cardiac work and weight)
  3. Atrial fib and flutter increase
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15
Q

What kind of strokes increase in obese men and women?

A

women increase risk ischemic stroke

men increase risk ischemic/ hemorrhagic stroke

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16
Q

What musculoskeletal diseases come about with obesity and what is the effects?

2

A

Ostoearthritis:

  1. Commonly develops in knees & ankles
  2. But also in non-weight-bearing joints
17
Q

Obese individuals are at a greater risk and have increased death rates for what kind of cancers?
7

A 
GI tract: Esophagus, Colon & Rectum 
Liver, Pancreas, and  Gallbladder
Kidney
Non-Hodgkin’s Lympphoma
Multiple Myeloma
Men-Prostate
Women-breast, uterus, cervix, ovary
18
Q

What respiratory issues come about with obesity and what is the pathology behind it?

A

Sleep apnea: the obstructive type

More tissue is there and encloses on the airway

19
Q

What kind of screening do we need to do for obesity?

A
  1. Measure height and weight
  2. Determine the BMI (females and males/ different BMI calculations for gender)
  3. Measure the weight circumference
20
Q

How would we treat obesity?

3

A

Decrease food intake
Increase energy expenditure
Behavior modification

21
Q

What should our goal be for decreasing food intake for weight loss?
2

A
  1. 1200-1600 cal/day
    dont go less than 1000
  2. loss of 5% of body weight by 6 months
22
Q

What do we want to work up to for exercise in treatment for obesity?

A

45 min 3-4 times a week

23
Q

What kind of behavior modifications do we want to put into place for the treatment of diabetes?
4

A
  1. Keep food diaries, look at eating patterns
  2. Activity diaries
  3. Identify and try to deal differently w/ eating triggers,
  4. look at motivation
24
Q

2 prominent ingrediants in OTC and herbal treatments for weight loss?

A 
Green tea (caffeine)
Chromium
25
Q

What does Lorcarserin (Belvaq) do?

A

Agonist of serotonin C2 receptors

Decreases Appetite

26
Q

What does Orlistat (Xenical, Alli) do?

A

lipase inhibitor, inhibits the absorption of dietary fats

causes bad side effects if you eat fay-promotes a low fat diet

27
Q

What does Phentermine (Adipex-P) do?

A

anorectic agent, amphetamine-like.

Increases metabolism and decrease in appetite

28
Q

Who do we never want to give weight loss medication to? 2

A

No one with addiciton or heart problems

29
Q

Indications for surgical therapy for obesity?

4

A
  1. Be well-informed and motivated

2. Have a BMI > 40 or BMI

30
Q

Contraindications for surgical therapy of obesity?4

A
  1. Those with untreated depression or psychosis
  2. Current drug or alcohol abuse
  3. Prohibitive surgical risks
  4. Inability to comply with lifelong diet and nutritional requirements
31
Q

How does the lap band surgery work?

A

Restricts how much food the top of the stomach holds. Youll get full faster

32
Q

Who would this surgery be good for specifically?

A

Good for a younger woman that want to have children because it can be reversible (deflate the band)

33
Q

What are some of the complications that can happen with sleeve gastrectomy?
3

A

Can get dumping syndrome:

  • eat too many carbs
  • gives you feedback when you’ve eaten something you arent supposed to
  • permanent and nonreversible
34
Q

How does gastric bypass work on the GI tract to cause weight loss?

A

Restrictive and malabsorptive

35
Q

How can Gastric bipass be accomplsihed surgically?

A

Can be laproscoptic but sometimes not

36
Q

Whats the average estimated weight loss over a year?

Over two years?

A

62-68%

50-70%

Intro to Clinical Medicine (12 decks)

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