Obesity and Metabolic Syndrome Exam 3

Question 1

What waist circumference would classify as metabolic syndrome for men and women?

Answer 1

Men: >40 inches
Women: >35 inches

Question 2

What fasting TG falls into metabolic syndrome?

Answer 2

TG > or = 150mg/dL

Question 3

What HDL is a risk for metabolic syndrome for men and women?

Answer 3

Men:

Question 4

What BP falls into metabolic syndrome?

Answer 4

> or = 130/85 mmHg

Question 5

What fasting blood glucose is metabolic syndrome?

Answer 5

> or = 100mg/dL

Question 6

How many diagnostic criteria are required for diagnosis of metabolic syndrome?

Answer 6

3 out of 5

Question 7

What are the modifiable causes of metabolic syndrome?

Answer 7

Weight, exercise, insulin resistance, and smoking

Question 8

What are the unmodifiable causes of metabolic syndrome?

Answer 8

Family history (diabetes, PCOS), race (AA or latino), age (>65), and gender (women>men)

Question 9

What is the end result of metabolic syndrome?

Answer 9

Doubled risk of heart disease, 5x risk DM, increased risk of blood clots, constant low grade inflammation, increased risk of stroke.

Question 10

What is the first area that must be addressed in metabolic syndrome?

Answer 10

Lifestyle changes

Question 11

What non-PCOL changes can be recommended in metabolic syndrome?

Answer 11

DASH or TLC diet, weight loss (BMI target

Question 12

What is the main target of the DASH diet?

Answer 12

Decrease in blood pressure through reduction of sodium intake, exercise, increased fruit/vegetable consumption.

Question 13

What is the main target of the TLC diet?

Answer 13

Decrease in cholesterol through increased soluble fiber intake, reduction in fat/oil calorie intake, and exercise.

Question 14

What weight category does a BMI of 30 fall into?

Answer 14

Obesity

Question 15

What weight category does a BMI of 37 fall into?

Answer 15

Severe obesity

Question 16

What BMI makes a patient a candidate for weight loss medication?

Answer 16

BMI >30 or >27 with 1+ additional comorbidity (DM, HTN, HLD, OSA) or failure of diet and exercise alone.

Question 17

How does phentermine (Adipex) cause weight loss?

Answer 17

Decreases appetite–stimulant like side effects b/c increased NE release.

Question 18

How does liraglutide (Saxenda) cause weight loss?

Answer 18

Slows gastric emptying, increased satiety

Question 19

How do naltrexone/buproprion and lorcaserin cause weight loss?

Answer 19

Decrease appetite

Question 20

How does orlistat (Xenical or Alli) cause weight loss?

Answer 20

Inhibits fat absorption in the gut

Question 21

What ADEs are concerns with liraglutide, naltrexone/buproprion, and lorcaserin? Which of these is best for patients with adherence issues?

Answer 21

HA, nausea, constipation

Lorcaserin

Question 22

What are the big concerns with orlistat?

Answer 22

Deficiency of fat soluble vitamins, drug absorption issues (not with narrow TI drugs), ADEs including lots of fecal issues

Question 23

What weight loss drug is cause for concern in seizure and in patients on chronic opioids?

Answer 23

Naltrexone/buproprion ER (Contrave)

Question 24

What weight loss medications are preferred in patients with uncontrolled HTN or cardiac arrhythmias?

Answer 24

Lorcaserin or orlistat

Question 25

When should weight loss be monitored?

Answer 25

Monthly for 3 months then q3mos after. If weight loss