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1Fall24 PoA II > Obesity (Exam III) > Flashcards

Obesity (Exam III) Flashcards

1
Q

What is the #1 cause of medically-related preventable deaths?

A
  • # 1 Smoking
  • Obesity is #2.
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2
Q

What is the formula to calculate BMI?

A

Kg/m²

100 kg patient that is 6 foot
6’ = 72”
1” = 2.54 cm
72” = 182.88 cm = 1.8288 m

100 kg / (1.8288²) ≈ 29.9 BMI

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3
Q

What are the classifications for BMI? (4)

A

≻30 = Obese
25-30 = Overweight
18.5-25 = Normal
≺18.5 = Underweight

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4
Q

What is an android body fat distribution associated with? (3)

A
  • Truncal/central obesity
  • ↑O₂ consumption
  • CV disease
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5
Q

Gynoid body fat distributions are _____ metabolically active and not as associated with ______ disease. How is gynoid obesity described?

A

less ; cardiovascular

Gynoid is more peripheral, including hips, buttocks, and thighs.

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6
Q

Total blood volume is ______ in obesity.

A

increased

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7
Q

Obesity blood volume to weight ratio is typically lower than _____ mL/kg.

A

50 mL/kg

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8
Q

What occurs with cardiac output in obese patients?

A

CO will ↑ by 20-30 mL per kg of excess body fat.

CO increases due to LV dilation and ↑ stroke volume.

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9
Q

What causes cardiac dysrhythmias in the obese patient? (2)

A
  • Fatty infiltrates in the conduction system
  • CAD
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10
Q

What EKG changes are typical of the obese patient? (3)

A
  • ↓ QRS voltage
  • LV hypertrophy
  • Left axis deviation
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11
Q

Increased levels of what coagulative factors are noted in obesity? (4) What does this lead to?

A
  • Fibrinogen
  • Factor VII
  • Factor VIII
  • Von Willebrand

Increased levels => hypercoagulability.

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12
Q

Why does endothelial dysfunction occur in the obese patient?

A

Due to ↑ factor VIII and von Willebrand.

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13
Q

Gastric ______ and _____ are increased in the obese patient.

A

Gastric volume and acidity are increased.

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14
Q

What aspiration risk factors are present in an Obese patient due to changes in the GI system? (3)

A
  • Delayed gastric emptying
  • ↑ chance of gastric volume > 25mL
  • ↑ chance of pH < 2.5
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15
Q

What are the results of increased intragastric pressure secondary to obesity? (2)

A
  • LES relaxation
  • Hiatal hernia formation
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16
Q

Glomerular _______ occurs with obesity due to increased ____________.

A

Glomerular hyperfiltration occurs with obesity due to increased renal blood flow.

17
Q

What are the consequences of increased renal tubular absorption secondary to obesity? (2)

A
  • Impaired natriuresis
  • RAAS activation
18
Q

What are the endocrine effects of obesity? (5)

A
  • ↑ SNS activity
  • Insulin resistance
  • Enhanced NE and ANG II activity
  • Na⁺ retention
  • Thyroid hormone resistance
19
Q

Metabolic syndrome diagnosis requires 3 of the following: (8)

A
  • Abdominal obesity
  • ↓ HDLs
  • ↑ Triglycerides
  • Hyperinsulinemia
  • Glucose intolerance
  • Hypertension
  • proinflammatory state
  • prothrombotic state
20
Q

What ethnicities are at higher risk for metabolic syndrome? Men or women?

A

Hispanics and South Asians
Men > women

21
Q

What drugs may cause metabolic syndrome? (4)

A
  • Chronic corticosteroids
  • Antidepressants
  • Antipsychotics
  • Protease inhibitors
22
Q

Differentiate OSA and hypopnea.

A
  • OSA: Complete cessation of breathing (5 times or more an hour)
  • Hypopnea: Airflow reduction by ≥ 50% (15 times or more an hour)
23
Q

What is another name for a sleep study for OSAHS? How is it reported?

A

Polysomnography

  • Reported as total # of events/total sleep time
24
Q

What would a mild apnea/hypopnea index be?

A

5 - 15 events/hour

25
Q

What would a moderate apnea/hypopnea index be?

A

15 - 30 events/hour

26
Q

What would a severe apnea/hypopnea index be?

A

> 30 events/hour

27
Q

CPAP and weightloss are necessary for treatment of OSAHS (Obstructive sleep apnea and hypopnea syndrome) due to risk of what complications? (4)

A
  • Systemic/Pulmonary HTN
  • LVH
  • Dysrhythmias
  • Cognitive impairment
28
Q

What’s another name for Obesity Hypoventilation Syndrome (OHS)?

A

Pickwickian Syndrome

29
Q

What causes Pickwickian syndrome?

A

Long-term OSA

30
Q

What does Pickwickian syndrome cause? (2)

A

Pulm HTN and Cor Pulmonale

31
Q

How is Pickwickian syndrome diagnosed? (2)

A
  • > 30 BMI
  • Awake hypercapnia
32
Q

What mentioned drug(s) classes are commonly used to treat obesity? (4)

A
  • Phentermine
  • Orlistat
  • OTC Herbals
  • GLP-1 Agonists
33
Q

How does Phentermine work?
What are it’s side effects? (4)

A
  • Sympathomimetic that decreases appetite
  • ↑HR, palpitations, HTN, dependence
34
Q

How does Orlistat work?
What are the adverse effects associated with it?

A
  • Orlistat blocks absorption of dietary fat
  • Liquid, fatty stools, urgency, flatulence and abd cramping.
  • Fat soluble vitamin deficiencies
35
Q

How can Orlistat precipitate coagulopathy?

A

Possible Vit K deficiency → prolonged PT

1Fall24 PoA II (34 decks)

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