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Rachel's APA Fund > Obesity > Flashcards

Obesity Flashcards

1
Q

T/F: Adipose tissue is considered an organ?

A

True

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2
Q

What is the 2nd leading cause of preventable death?

A

Obesity

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3
Q

How to calculate BMI?

A

Weight (Kg) / Height (m2)

or {Weight (lbs)/Height(in2)} x 703

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4
Q

BMI Classes

A 
25-29.9=Overweight
30-34.9=Obese Class 1
35-39.9=Obese Class 2
40-44.9=Obese Class 3
>45= Obese Class 4
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5
Q 
Which class is considered Extreme Obesity?
Severe Obesity?
A

Extreme Obesity=Class 3 (BMI 40-44.9)

Severe Obesity=Class 4 (BMI >45).

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6
Q

What is the typical cutoff BMI for Surgery centers?

A

BMI >45

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7
Q

What is the Broca’s Index?

A

A formula to calculate Ideal Body Weight

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8
Q

What is the Ideal Body Weight Formula?

A 
Male= Height(cm)- 100
Female= Heigh(cm)- 105
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9
Q

How do you calculate Lead Body Weight?

A

First calculate IBW and multiply by 1.3

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10
Q

Which adipose distribution is labeled as “Apple Shaped”?

A

Android

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11
Q

Which adipose distribution is labeled as “Pear Shaped”?

A

Gynecoid

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12
Q

Which adipose distribution (Gynecoid/Android) is associated with heart disease, DM, HTN, dyslipidemia, death?

A

Android

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13
Q

How does cardiac output change with obesity?

A

Increased CO of 0.1L/min for each kg of fat

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14
Q

What are reasons for HTN prevalence in obesity?

A
  1. Increased blood viscocity
  2. Hyperinsulinemia
  3. Increased mineralocorticoids
  4. Sodium reabsorption
  5. Compression of kidneys
  6. RAA Activation
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15
Q

Do obese patients exhibit restrictive or obstructive respiratory loop patterns?

A

Restrictive

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16
Q

What is changed on flow volume loops in the obese patient?

A

Decreased: FRC, ERV, VC, TLC
Increased: Deadspace
No change: RV, CC, FVC, FEV1

17
Q

What is the definition of OSA?

A

Excessive episodes of apnea (10 seconds) with >5 episodes per hour or 30 per night

18
Q

T/F: OSA is very well diagnosed and most patients are treated for it adequately?

A

False; 80-95% are undiagnosed and/or untreated

19
Q

What is the “Gold Standard” test for OSA?

A

Polysomnography (PSG)

20
Q

What easy scoring parameter can be used to diagnose OSA with 93% sensitivity?

A

STOP-BANG

21
Q

What does STOP BANG stand for?

A 
Snoring
Tiredness
Observed apnea
Pressure (HTN)
BMI (>35)
Age (>50)
Neck (>15.75in)
Gender (Male)
22
Q

What is Pickwickian syndrome?

A

Obese Hypoventilation Syndrome

Typically have OSA induced polycythemia, respiratory acidosis, PulmHTN, R CHF

23
Q

Why do Pickwickian syndrome patients acquire Right sided heart failure?

A

Hypoxic Pulmonary Vasoconstriction which leads to Pulmonary HTN

(Cor Pulmonale)

24
Q

T/F: Maternal obesity is related to pregnancy complications; however, these risks are decreased after bariatric surgery?

A

False; complication risk increased after bariatric surgery

25
Q

Propofol induction doses are based on ____(LBW/IBW/TBW) versus maintenance infusion doses based on ____(LBW/IBW/TBW)?

A

Induction dose based on LBW.

Maintenance gtt based on TBW

26
Q

Which medication must be based on TBW due to the increased fluid compartment and increased pseudocholinesterase levels?

A

Succinylcholine

27
Q

Roc/Vec/Cisat should be based on ____(LBW/IBW/TBW) and why?

A

IBW. Hydrophilic drug; will ensure shorter duration of action and more predictable recovery time

28
Q

Fentanyl and sufentanyl should be based on ____ (LBW/IBW/TBW) for induction and ____ for infusions?

A

TBW d/t increased distribution volume, but infusions should be based off LBW

29
Q

Low lipophilicity drugs should be based on ___(LBW/IBW/TBW)?

A

IBW

30
Q

High lipophilicity drugs should be based on ____ (LBW/IBW/TBW)?

A

TBW

31
Q

Describe “sniffing” position:

A

Extension at atlanto-axial joint.

Flexion at lower cervical vertebrae

32
Q

Obesity changes with GA on Respiratory?

A
  1. 50% reduction in FRC compared to 20% in non-obese
  2. Use PEEP
  3. TV 6-10ml/kg off IBW
  4. Intermittent manual “sighs”
33
Q

How does the obese patients volume replacement change?

A

Use 45-55ml/kg for for EBV.

Increased Total Body Volume, but proportionately decrease Estimated Blood Volume

Rachel's APA Fund (2 decks)

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