Obesity (Cornelius) Exam III Flashcards
Which of the following is the second leading cause of preventable deaths, only behind smoking?
A. Obesity
B. Diabetes
C. Cardiovascular disease
D. Cancer
A. Obesity
Slide 2
What percentage of Americans are considered overweight or obese?
A. 25%
B. 36%
C. 55%
D. 62%
B. 36%
Slide 2
Globally, how many people are classified as obese?
A. 1 billion
B. 100 million
C. 400 million
D. 800 million
C. 400 million
Slide 2
More than __________ people are overweight worldwide, with over __________ million cases and __________ deaths attributed to coronavirus.
A. 2 billion; 53.2; 1.2 million
B. 1.6 billion; 33.2; 999K
C. 1.2 million; 22.3; 500K
D. 1.3 billion; 47.3; 750K
B. 1.6 billion; 33.2; 999K
Slide 2
Obesity ranks as the __________ leading cause of preventable deaths, only behind __________.
A. First; cardiovascular disease
B. Third; alcohol consumption
C. Second; smoking
C. Second; smoking
Slide 2
Which factors influence obesity? (Select 4)
A. Metabolic and behavioral factors
B. Excessive exercise
C. Cultural factors
D. Hormones
E. Socioeconomic factors
F. Exposure to extreme heat/cold
A. Metabolic factors and behavioral factors,
C. Cultural factors,
D. Hormones,
E. Socioeconomic factors
Slide 2
The Body Mass Index (BMI) is calculated by dividing a patient’s __________ (in kg) by their __________ squared (in meters).
A. Weight; height
B. Height; weight
C. Weight; hip ratio
D. Age; waist circumference
A. Weight; height
Patient weight (kg)/ height2 in meters = kg/m²
slide 3
Which of the following is true about the Body Mass Index (BMI)?
A. It is the most widely applied tool for assessing body weight.
B. It differentiates between overweight and overfat.
C. It takes into account waist circumference, waist-hip ratio, and age.
D. It measures body fat directly.
A. It is the most widely applied tool for assessing body weight.
Slide 3
Which factors are not considered in the calculation of Body Mass Index (BMI)? (Select 4)
A. Muscle mass
B. Waist circumference
C. Height and weight
D. Waist-hip ratio
E. Age
A. Muscle mass
B. Waist circumference
D. Waist-hip ratio
E. Age
Slide 3
BMI is the most widely applied tool to assess body weight, but it does not differentiate between __________ and __________.
A. Overweight; overfat
B. Waist circumference; height
C. Muscle mass; fat mass
D. Age; gender
A. Overweight; overfat
Slide 3
Android fat distribution is primarily characterized by which type of obesity?
A. Peripheral obesity
B. Central obesity
C. Lower body obesity
D. Diffuse obesity
B. Central obesity
Slide 4
Which of the following is characteristic of android (central) obesity?
A. Peripheral fat distribution
B. Decreased oxygen consumption
C. Associated with upper body fat
D. Not associated with cardiovascular disease
C. Associated with upper body (truncal) fat
Slide 4
Which of the following factors are associated with android obesity? (Select 2)
A. Increased oxygen consumption
B. Peripheral fat distribution
C. Higher cardiovascular disease risk
D. Less metabolically active
A. Increased oxygen consumption
C. Higher cardiovascular disease risk
Slide 4
Which of the following are characteristics of gynecoid (peripheral) obesity? (Select 3)
A. Upper body fat
B. Found in buttocks
C. Found in hips
D. Found in upper arms
E. Found in thighs
B. Found in buttocks
C. Found in hips
E. Found in thighs
Slide 4
Gynecoid obesity is also referred to as “__________” obesity and is considered _______ metabolically active.
A. central; more
B. peripheral; less
C. visceral; less
D. peripheral; more
B. peripheral; less
Slide 4
True or False
Gynecoid obesity is not associated with CV disease
True
Slide 4
What is a key cardiac change observed in obesity?
A. Decreased total blood volume
B. Increased total blood volume
C. Decreased cardiac output
D. Increased heart rate
B. Increased total blood volume
Slide 5
Total blood volume increases in obesity, but on a volume-to-weight ratio, it is lower at _______ mL/kg.
A. 50
B. 60
C. 40
D. 70
A. 50
Slide 5
The total blood volume is most distributed to __________ tissue in obesity.
A. Skeletal
B. Connective
C. Nervous
D. Adipose
D. Adipose
Slide 5
In obesity, cardiac output increases by _______ mL/kg of excess body fat.
A. 5-10
B. 10-15
C. 20-30
D. 30-40
C. 20-30
Slide 5
Cardiac output increases in obesity due to:
A. Increased stroke volume and left ventricular dilation
B. Decreased stroke volume and right ventricular dilation
C. Increased heart rate and decreased oxygen consumption
D. Decreased stroke volume and right ventricular contraction
A. Increased stroke volume and left ventricular dilation
Cornelius: to perfuse that increased tissue
Slide 5
Cardiac dysrhythmias in obesity are commonly caused by fatty infiltrates in the _______ system and _______
A. Conduction; CAD
B. Vascular; PVD
C. Respiratory; ARDS
D. Lymphatic; CAD
A. Conduction; CAD
Slide 5
Which of the following are common cardiac dysrhythmias seen in obesity? (Select 3)
A. Low QRS voltage
B. Right axis deviation
C. Left ventricular hypertrophy
D. Left axis deviation
E. High QRS voltage
F. Right ventricular hypertrophy
A. Low QRS voltage,
C. Left ventricular hypertrophy (LVH),
D. Left axis deviation
Cornelius - when you look at their EKG, just because of the distance between the monitoring side and the heart there’s a kind of a decrease in the QRS voltage or amplitude and then you may also notice that left axis deviation and then the LVH
Slide 5
Which factors are increased in the hematologic system of obesity, contributing to hypercoagulability?
A. Fibrinogen, Factor VII, Factor VIII, von Willebrand
B. Platelets, Hemoglobin, Hematocrit, von Willebrand
C. Fibrinogen, Factor V, Platelets, Factor IX
D. Platelets, Factor II, von Willebrand, Factor IX
A. Fibrinogen, Factor VII, Factor VIII, von Willebrand
C - see a higher level of clotting factors, which is problematic just because they have so much more vasculature. They tend to have an increased incidence of clotting disorders. So things like DVTs, PEs are a little bit more predominant and then you couple that with their decreased activity level.
Slide 6
True or False
When a obese person gets microclots they tend to have less symptoms due to accessory pathways created over time.
True
Corndog - …because of their decreased activity level, they tend to be less symptomatic than patients that are more active and have a large P/E.
They tend to have like a serial of events, not just like a one time.
A lot of times you’ll see that if they mobilize or experience some sort of life change that they’ll start showering little micro clots. As a result of that, they kind of build up a accessory pathway that lets them get through the event a little bit easier..
slide 6
What is one of the main consequences of increased levels of von Willebrand factor and factor VIII in obesity?
A. Thrombocytopenia
B. Endothelial dysfunction
C. Increased oxygen carrying capacity
D. Anemia
B. Endothelial dysfunction
Slide 6
In obesity, gastric volume and acidity are increased, leading to delayed ________ and increased risk of aspiration pneumonitis.
A. Peristalsis
B. Gastric emptying
C. Intestinal absorption
D. Metabolism
B. Gastric emptying
slide 7
What gastric volume and pH levels are risk factors for aspiration pneumonitis in obese patients?
A. Volume > 25 mL and pH > 2.5
B. Volume < 25 mL and pH > 2.5
C. Volume > 25 mL and pH < 2.5
D. Volume < 25 mL and pH < 2.5
C. Volume > 25 mL and pH < 2.5
Slide 7
_________ function is often altered in patients with obesity, affecting drug metabolism.
A. Renal function
B. Cardiac function
C. Endocrine function
D. Hepatic function
D. Hepatic function
Slide 7
Relaxation of the _______ and formation of a hiatal hernia are common complications in the GI system of obese patients.
A. Lower esophageal sphincter (LES)
B. Upper esophageal sphincter (UES)
C. Pyloric valve
D. Duodenal sphincter
A. Lower esophageal sphincter (LES)
C - ..because of the body habitus, you also tend to see that there’s an increase in the intragastric pressure, and as a result of that, that lower esophageal sphincter will relax a little bit and they tend to form a hiatal hernius.
You will also see that when patients go in for like sleeve gastrectomies or lap bands, that commonly they will have a hiatal hernia repair as well.
Slide 7
What is one of the renal effects of obesity that increases renal blood flow?
A. Glomerular hyperfiltration
B. Decreased renal blood flow
C. Increased natriuresis
D. Glomerular hypofiltration
A. Glomerular hyperfiltration
Slide 8
Which renal system mechanisms are typically impaired in obesity? (Select 3)
A. Glomerular filtration
B. Natriuresis
C. Renal tubular reabsorption
D. Renin-angiotensin activation
B. Natriuresis
C. Renal tubular reabsorption
D. Renin-angiotensin activation
Brian G. Cornelius - they’ll have a little bit more increase in blood pressure.
So it’s kind of a constant battle for these folks regulating the miles of vasculature. Regulating their fluid status and the kind of pairing that with the decrease in activity.
Slide 8
Which of the following are consequences of increased SNS activity in obesity? (Select 3)
A. Insulin resistance
B. Enhanced pressor activity of norepinephrine
C. Sodium retention
D. Decreased angiotensin II activity
E. Sodium excretion
A. Insulin resistance
B. Enhanced pressor activity of norepinephrine and angiotensin II
C. Sodium retention
Slide 9
Which of the following are effects of thyroid hormone resistance in morbidly obese patients? (Select all that apply-2)
A. Increased metabolic rate
B. Hypothyroidism
C. Decreased sodium retention
D. Impaired glucose metabolism
B. Hypothyroidism,
D. Impaired glucose metabolism
C - Diabetes, POTs, chronic pain syndromes, those sorts of things tend to go hand in hand with a lot of these same patients.
Slide 9
What percentage of morbidly obese patients suffer from hypothyroidism due to thyroid hormone resistance?
A. 10%
B. 25%
C. 50%
D. 75%
B. 25%
Slide 9
Which of the following diseases are commonly associated with obesity? (Select 4)
A. Type 2 diabetes mellitus
B. Osteoarthritis
C. Hypertension
D. COPD
E. Alzheimer’s disease
F. Rheumatoid Arthritis
A. Type 2 diabetes mellitus - “side effect”
B. Osteoarthritis - increased wear and tear on their joints as a result of the high body habitus.
C. Hypertension,
D. Chronic obstructive pulmonary disease (COPD)
Slide 10
Which of the following diseases are commonly associated with obesity? (Select 4)
A. Obstructive sleep apnea
B. Asthma
C. Cardiovascular disease
D. Cancer
E. Renal failure
F. Hyperthyroidism
A. Obstructive sleep apnea - “side effect of obesity”
B. Asthma
C. Cardiovascular disease
D. Cancer
Slide 10
A diagnosis of metabolic syndrome requires at least ___ of the defining criteria to be present.
A) 2
B) 3
C) 4
D) 5
B) 3
Slide 11
Which of the following are the most *common causes of metabolic syndrome as stated by Dr. Cornelius and starred * in the lecture slide? (Select 5)
A) Abdominal obesity
B) Decreased levels of HDL
C) Hypertriglyceridemia
D) Glucose intolerance
E) Hypertension
F) Prothrombotic state
G) Proinflammatory state
A) *Abdominal obesity
B) *Decreased levels of HDL
C) *Hypertriglyceridemia
D) *Glucose intolerance
E) *Hypertension
Cornelius: cluster of what we used to use to define diabetes and the symptoms that go along with it… more of a progression than just one point in time.
Slide 11
Which of the following are metabolic abnormalities associated with metabolic syndrome? (Select 3)
A) Hyperinsulinemia
B) Increased HDL
C) Proinflammatory state
D) Hypotriglyceridemia
E) Prothrombotic state
A) Hyperinsulinemia
C) Proinflammatory state
E) Prothrombotic state
Slide 11
Which of the following is used to assess metabolic syndrome instead of BMI?
A) Waist circumference
B) Body fat percentage
C) TBW
D) Body water content
A) Waist circumference
Slide 12
Which gender is more likely to be affected by metabolic syndrome?
A) Women
B) Men
C) Both are equally likely
D) Gender is not a factor
B) Men
Slide 12
Metabolic syndrome is more prevalent in ________ compared to other groups.
A) African Americans and Pacific Islanders
B) Hispanics and South Asians
C) Caucasians and Non-Hispanic
D) Hispanics and African Americans
B) Hispanics and South Asians
Slide 12
Metabolic syndrome may result from the chronic use of which of the following medications? (Select 4)
A) Corticosteroids
B) Antidepressants
C) Antipsychotics
D) Antibiotics
E) Protease inhibitors
F) Antifungals
A) Corticosteroids,
B) Antidepressants,
C) Antipsychotics,
E) Protease inhibitors
Slide 12
Metabolic syndrome increases the risk of which of the following conditions?
A) Cardiovascular disease
B) Alzheimer’s disease
C) Psoriasis
D) Autism
A) Cardiovascular disease.
C - He keeps mentioning POTS - so here is a definition from the Google -
POTS: Signs and Symptoms
Postural orthostatic tachycardia syndrome (POTS) is a chronic condition that causes an abnormally rapid heart rate when standing up or sitting up.
Slide 13
Metabolic syndrome increases the risk of which of the following diseases? (Select 3)
A) Gastrointesinal disease
B) Type 2 diabetes mellitus
C) Nonalcoholic fatty liver disease
D) Multiple sclerosis
E) Polycystic ovary syndrome
B) Type 2 diabetes mellitus,
C) Nonalcoholic fatty liver disease,
E) Polycystic ovary syndrome (PCOS)
Slide 13
______% of metabolic syndrome cases are resolved with bariatric surgery or weight loss goals.
A) 60%
B) 75%
C) 98%
D) 50%
C) 98%
Slide 13
Obstructive Sleep Apnea (OSA) is characterized by which of the following?
A) Complete cessation of breathing lasting less than 5 seconds
B) Complete cessation of breathing
C) Reduction in airflow by 50%
D) Cessation of breathing only during exercise
B) Complete cessation of breathing
Slide 14
Which of the following are characteristics of Obstructive Sleep Apnea (OSA)? (Select 3)
A) Complete cessation of snoring
B) Lasting 10 seconds or more
C) Occurs more than 5 times per hour of sleep
D) Decreases oxygen saturation by 10%
E) Decreases oxygen saturation by 4%
B) Lasting 10 seconds or more,
C) Occurs more than 5 times per hour of sleep
E) Decreases oxygen saturation by 4%
Slide 14
Which of the following criteria is associated with hypopnea?
A) Reduction in airflow by 50% or more and lasting 5 seconds or less
B) Reduction in airflow by 30% or more and lasting 20 seconds or more
C) Reduction in airflow by 50% or more and lasting 10 seconds or more
D) Reduction in airflow by 10% or more lasting 10 seconds or less
C) Reduction in airflow by 50% or more lasting 10 seconds or more
Slide 14
Which of the following are characteristics of hypopnea? (Select 2)
A) Reduction in airflow by 50% or less
B) Lasting less than 5 seconds
C) Occurs more than 15 times per hour of sleep
D) Decreases oxygen saturation by 4%
E) Reduction in oxygen levels by 20%
C) Occurs more than 15 times per hour of sleep,
D) Decreases oxygen saturation by 4%
C - Same kind of duration, same decrease in SPO2, but they’re having an actual airflow reduction.
So as far as like testing a lot of times, these patients will not only have monitoring for oxygen saturation, but they’ll also do spirometry while they’re testing them.
Slide 14
What is another term for the sleep study used to diagnose OSAHS?
A) Echocardiogram
B) Polysomnography
C) Electroencephalogram
D) Spirometry
B) Polysomnography
Slide 15
The apnea/hypopnea index (AHI) classifies severe OSAHS as how many events per hour?
A) 5-15 events per hour
B) 15-30 events per hour
C) >30 events per hour
D) 20-25 events per hour
C) >30 events per hour
Slide 15
The apnea/hypopnea index (AHI) classifies moderate OSAHS as having ______ events per hour.
A) 5-10
B) 15-30
C) 25-40
D) 10-20
B) 15-30
Slide 15
The apnea/hypopnea index (AHI) classifies mild OSAHS as how many events per hour?
A) 5-15 events per hour
B) 15-30 events per hour
C) >30 events per hour
D) 20-25 events per hour
A) 5-15 events per hour
Slide 15
Which of the following are included in the treatment strategies for moderate/severe OSAHS? (Select 2)
A) CPAP
B) Cognitive therapy
C) Use of diuretics
D) Weight loss
E) Sleep medication
B) CPAP,
D) Weight loss
Slide 15