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KLowe-Advanced Anes 2 (Rachel's Class) > Obesity > Flashcards

Obesity Flashcards

1
Q

Adipose tissue is considered an organ–T/F?

A

True!

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2
Q

What are (2) formulas that can be used to calculate BMI?

A

BMI = weight (kg) / height (m^2)

BMI = [weight (lbs) / height (in^2)] x 703

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3
Q

BMI class (ASA)–overweight = ___-___

A

25-29.9

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4
Q

BMI class (ASA)–obese class I = ___-___

A

30-34.9

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5
Q

BMI class (ASA)–obese class II = ___-___

A

35-39.9

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6
Q

BMI class (ASA)–obese class III/extreme obese = ___-___

A

40-44.9

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7
Q

BMI class (ASA)–obese class IV/severe obesity = > ___

A

> 45

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8
Q

How to calculate ideal body weight (IBW) for males and females using Broca’s index?

A

Male = height (cm) - 100

Female = height (cm) - 105

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9
Q

How to calculate lean body weight (LBW)?

A

IBW x 1.3

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10
Q

What type of fat distribution is central or abdominal visceral; patients are apple shaped?

A

Android

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11
Q

What type of fat distribution is gluteal, femoral, or peripheral; patients are pear shaped?

A

Gynecoid

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12
Q

Which type of obesity (android or gynecoid) is associated with more comorbidities?

A

Android

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13
Q

What (5) things is android obesity associated with?

A
  • Heart disease
  • Diabetes mellitus
  • Hypertension
  • Dyslipidemia
  • Death
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14
Q

What (2) things is gynecoid obesity associated with?

A
  • Varicose veins

- Joint disease

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15
Q

There is a/an ___ (increased/decreased) metabolic demand from fat organs

A

There is an INCREASED metabolic demand from fat organs

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16
Q

Increased cardiac output of ___ L/min for each kg of fat

A

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

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17
Q

HTN in obesity is defined as SBP > ___, DBP > ___, or both

A

HTN in obesity is defined as SBP > 140, DBP > 90, or both

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18
Q

Respiratory–obese patients have ___ (increased/decreased) lung compliance; why?

A

Obese patients have DECREASED lung compliance; d/t pressure from abdominal, diaphragmatic, and thoracic fat

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19
Q

Obese patients have a ___ F/V loop pattern

A

Obese patients have a RESTRICTIVE F/V loop pattern

20
Q

Obese patients have ___ (increased/decreased) FRC, ERV, VC, TLC; ___ (increased/decreased) dead space; ___ (increased/decreased/no change) in RV, CC, FVC, and FEV1

A

Obese patients have DECREASED FRC, ERV, VC, TLC; increased dead space; no change in RV, CC, FVC, and FEV1

21
Q

Obese patients ___ventilate, which leads to ___carbia and ___osis

A

Obese patients HYPOventilate, which leads to HYPERcarbia and acidosis

22
Q

What volumes/capacities are decreased in obese patients?

A

Decreased

  • FRC
  • VC
  • TLC
  • ERV
23
Q

What volumes/capacities show no change in obese patients?

A

No change

  • RV
  • CC
  • FVC
  • FEV1
24
Q

OSA rates are directly proportional to ___

A

OSA rates are directly proportional to BMI

25
Q

Risk factors for OSA–BMI > ___, ___ fat distribution, large ___ girth

A

Risk factors for OSA–BMI > 35, abdominal fat distribution, large neck girth

26
Q

For BMI > 35, OSA occurs in 71-77% of patients–T/F?

A

True

27
Q

What is OSA defined as?

A

Excessive episodes of apnea (10 seconds) and hypopnea

28
Q

What exactly occurs during episodes of apnea?–obstruction leads to ___ia and ___carbia, surge of muscles to open airway, period of ___ventilation reverses ___carbia, ___ breathing, repeat

A

obstruction leads to hypoxia and hypercarbia, surge of muscles to open airway, period of hyperventilation reverses hypercarbia, normal breathing, repeat

29
Q

OSA includes > ___ episodes of apnea per hour or ___ per night

A

OSA includes > 5 episodes of apnea per hour or 30 per night

30
Q

OSA leads to ___ia, ___carbia, ___ and ___ hypertension, and cardiac ___

A

OSA leads to hypoxia, hypercarbia, systemic and pulmonary hypertension, and cardiac arrhythmias

31
Q

80-95% of patients who have OSA are undiagnosed–T/F?

A

True

32
Q

What is the gold standard test for OSA?

A

Polysomnography (PSG)

33
Q

What questionnaire can we use to evaluate patients for OSA and has up to 93% sensitivity?

A

STOP-BANG

34
Q

What does STOP-BANG stand for?

A

S-Snoring (Do you snore loudly?)
T-Tiredness (Do you often feel tired, fatigued, or sleepy during the daytime?)
O-Observed apnea (Has anyone observed that you stop breathing, or choke or gasp during your sleep?)
P-high blood Pressure (Do you have or are you being treated for high blood pressure?)
B-BMI (Is your body mass index more than 35 kg per m^2?)
A-Age (Are you older than 50 years?)
N-Neck circumference (Is your neck circumference greater than 40 cm [15.75 inches]?)
G-Gender (Are you male?)

35
Q

What syndrome does this describe?–inappropriate and sudden somnolence, OSA, hypoxia, hypercapnia, arterial hypoxemia, cyanosis-induced polycythemia, respiratory acidosis, pulmonary hypertension, right sided heart failure

A

Obese hypoventilation (Pickwickian) syndrome

36
Q

Obese hypoventilation (Pickwickian) syndrome can lead to what? How?

A

Right heart failure d/t hypoxic pulmonary vasoconstriction (AKA cor pulmonate)

37
Q

Pediatric obesity classifications–weight for height ratio > ___%, BMI > ___%

A

weight for height ratio > 90%, BMI > 95%

38
Q

Pharmacology in obese patients–___ (increased/decreased) volume of distribution; ___ (increased/decreased) blood volume; ___ (increased/decreased) total body water

A

increased volume of distribution; increased blood volume; decreased total body water

39
Q

IBW vs. TBW–for drugs with LOW lipophilicity, use ___

A

for drugs with LOW lipophilicity, use IBW

40
Q

IBW vs. TBW–for drugs with HIGH lipophilicity, use ___

A

for drugs with HIGH lipophilicity, use TBW (most of the time)

i.e.: digoxin, remifentanil, procainamide

You want to use their TBW because they have increased volume of distribution for lipid-soluble drugs (there’s more area for the drug to be distributed to)

41
Q

Pharmacokinetic changes associated with obesity–___ (increased/decreased) fat mass; ___ (increased/decreased) cardiac output; ___ (increased/decreased) blood volume; ___ (increased/decreased) lean body weight; ___ (increased/decreased) total body water; ___ (increased/decreased) renal clearance; ___ (increased/decreased) volume of distribution of lipid-soluble drugs

A

increased fat mass; increased cardiac output; increased blood volume; increased lean body weight; decreased total body water; increased renal clearance; increased volume of distribution of lipid-soluble drugs

42
Q

Effects of general anesthesia–obese patients have __% reduction in FRC compared to ___% in non-obese patients

A

Obese patients have 50% reduction in FRC compared to 20% in non-obese patients

43
Q

Tidal volumes in obese patients–___-___ ml/kg of ___ (IBW or TBW) for volumes

A

6-10 ml/kg of IBW for volumes

44
Q

Volume replacement for obese patients–increased ___ volume, but proportionately decreased ___ volume

A

increased total body volume, but proportionately decreased estimated blood volume

45
Q

EBV in obese patients–use ___-___ ml/kg

A

use 45-55 ml/kg

KLowe-Advanced Anes 2 (Rachel's Class) (16 decks)

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