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BioScience II > Obesity PPT-Josh > Flashcards

Obesity PPT-Josh Flashcards

1
Q

what is the WHO definition of BMI categories for obesity

A
  • Overweight > or = 25
  • Obese > 30
  • Obese I : 30-34.9
  • Obese II: 35-39.9
  • Obese III: >40
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2
Q

what is the BMI calculation

A

BMI= KG / height in meters2

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3
Q

how to calculate IBW

A
  • Women
    • 100 + 5 lbs for each inch > 5 foot
    • Or Cm- 105
  • Men
    • 105 + 6 lbs for each inch > 5 foot
    • Or cm-100
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4
Q

fat deposition:

what are the two man shapes?

A

apple

Pear

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5
Q

fat deposition:

which one are you?

A

j/k that sucks I think I am both

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6
Q

fat deposition:

other name for Pear shape

A

Gynecoid

( how to remember-Think of a pear this is a divit (crease) in the bottom middle like a vagina AKA GYN)

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7
Q

fat deposition:

Another name for apple shape?

A

Android

(how to remember- Apples competition is the android)

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8
Q

fat deposition:

where is fat placed at w/ pear

A

hips more than waist

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9
Q

fat deposition:

where is fat placed for apple

A

waist more than hip

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10
Q

fat deposition:

which shape is considered better?

A

Pear

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11
Q

fat deposition:

the apple is often associated w/ what syndrome

A

Metabolic syndrome

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12
Q

Obesity:

Obesity can also be associated w/ certain d/o and conditions (besides just over eating) what are they?

A
  • Cushings Syndrome (release of cortisol)
  • Hypothyroid (underactive thyroid)
  • Neurological disturbances ( hypothalamus damage as it regulates appetite)
  • Drug induced (steroids, antipsychotics, antidepressants)
  • Psychological (emotional eating)
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13
Q

what changes occur r/t to obesity to the Cranium

A

Benign Intracranial HTN

H/A dizziness

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14
Q

what changes occur r/t to obesity to the locomoter system

A
  • weight related musculoskeletal d/o; arthritis
  • Trapped nerves
  • Gout
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15
Q

what changes occur r/t to obesity to GU system

A
  • Kidney disease
  • Uturine CA
  • Prostate CA
  • Pregnancy problems
  • Stress incontinence
  • Polycystic ovary disease
  • Infertility
  • ED
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16
Q

what changes occur r/t to obesity to the metabolic system

A
  • NIDDM
  • Dyslipidemia
  • Impaired glucose tolerance
  • raised uric acid (Gout)
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17
Q

what changes occur r/t to obesity to the neuropsychiatric system

A
  • Macular degeneration
  • Alzheimers
  • Depression
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18
Q

what changes occur r/t obesity to the Vascular and CV system

A
  • Stroke
  • HTN
  • CAD
  • thrombosis
  • HF
  • Varicose veins
  • Oedema
  • A-Fib
  • Arrhytmias
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19
Q

what changes occur r/t obesity to the GI system

A
  • Gallstones
  • Hiatus Hernia
  • Colon CA
  • Fatty liver (cirrhosis)
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20
Q

what changes occur r/t obesity to the respiratory system

A
  • Breathlessness
  • OSA
  • Hypoventilation
    *
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21
Q

what changes occur r/t obesity to other systems not previously mentioned

A
  • Breast Ca
  • Hirsuitism
  • Sweating
  • Sweat rashes
22
Q

In what ways does obesity cause a potential problematic Airway

A
  • IGD <3 cm
  • short TMD
  • limited head and neck extension
  • Poor Mallampati
  • Increased Body weight
  • Short, thick necks
23
Q

Obesity:

what are the 2 main complications in teh obese ot, r/t Oxygen

A

increased demand

Decreased supply

24
Q

Obesity: Pulmonary

the increased demand (metabolic demands of “fat organs”) results in what 3 events

A

Increased demand

  1. Increase O2 consumption
  2. Increased CO2 production
  3. Increased Alveolar ventilation
25
Obesity: Pulmonary the decreased supply of O2 (r/t abd and chest wall fat) causes what?
* decreased chest wall compliance * decreased lung volumes * decreased FRC * premature airway closure * V/Q mismatch * Arterial Hypoxia * Increased work of breathing * decreased respiratory muscle efficiency
26
what is another name for Obesity Hypoventilation Syndrome?
Pickwickian syndrome
27
Pickwickian Syndrome: what the fuck is its characteristics
* Hypercapnia * Hypoxia * Periodic breathing * Excessive daytime sleepiness * Snoring
28
Pickwickian Syndrome: leads to strain on the hear that can cause what?
* Biventricular enlargement ( RT\>LT) * Dependent edema * Polycythemia * Pulmonary edema * Cor Pulmonale
29
Pickwickian Syndrome: what is the treatment
* best is weight loss * next is CPAP
30
Obesity: Morbidity and mortality are predominantly due to CV diseases, what are the main 3
* Ischemic heart disease * HTN * Cardiac failure
31
Obesity: there is an increased CO of \_\_\_\_L/min for each KG of fat acquired
o.1L/min
32
Obesity: is CHF associated w/ fatty infiltration of the myocardium due to obesity
NOPE
33
Obesity: Preop what questions should you ask for hx
* Duration of obesity * Past MI, HTN, or pVD * Excercise tolerance * Orthopnea * Paraxysmal nocturnal dyspnea * Current meds * Diet pills
34
Obesity: PE what do you wat to assess for
* Orthopnea * Symptoms * Assess airway * ROM
35
Obesity: Test what test do you want preop on these fat assess
* CBC * Urine * LFT * ECG * ECHO * ABG * X-ray *
36
Obesity:Airway a neck circumference of \> than ____ inches in men or ____ inches in women may indicates undiagnosed OSA
men 17 Women 16
37
Obesity:Airway what problems may you run into
* diff mask ventilation ( big cheeks, short neck, restrictions in mouth opening, Limited cervical and mandible movements) * ETT placement more difficult (excessive palatal and pharyngeal soft tissue * De-sat quick * Ventilatory depressent drugs cause faster de-sat * OHS (AKA OSA)
38
Obesity: Pharmacology lipophilic drugs have what effect
* Larger Vd and thus longer elimination 1/2 life (hang around longer) (i like to thinks of these drugs as black men.. They love fat, thus They marry our fat white chicks and HANG around them longer)
39
Obesity: Pharmacology Certain liphophilic drugs are exceptions and have normal Vd, what are a few of them
remifentanil Digoxin procainamide
40
Obesity: Pharmacology most routine anesthestic drugs listed require an initial bolus on TBW, but maintence dosing is based upon what? Benzos Barbs Narcs Fenanyl
IBW
41
Obesity: Pharmacology paralytics such as roc and vec are dosed according to what?
IBW
42
Obesity: Pharmacology how is Unfractionized heparin, enoxaprain, and vancomycin dosed
TBW
43
Obesity: Intraop Monitors and getting ready.. what to you wanna do
* Standard monitors * Venous access (no shit) * PREOXYGENATE 3-5 min * Poss AFOI * Cricord pressure
44
Obesity: Intraop effects on CV the degree of cardiac abnormality is correlated w/ the degree of obesity: what are usual CV symptoms we must be midfull of
* LV dysfucntion * HTN * Increased pre-load/afterload * Increased PAP
45
Obesity: Intraop effects on Pulmonary the degree of pulmonary abnormality is correlated w/ the degree of obesity: what are usual Pulmonary symptoms we must be midfull of
* Increased O2 consuption and CO2 production * Increased Work of breathing * Decreased chest wall compliance * Anesthesia leads to a 50% decrease in FRC (in normal pt's only leads to a 20% decrease)
46
Obesity: Intraop management what is the prefered mode of ventilation
controlled ventilation w/ LARGE Tv
47
Obesity: Intraop management what is a big pro and con of PEEP with fatties
* May improve Oxygenation, but associated w/ decrease in CO
48
Obesity: Postop management if extubating on table what position should you consider?
reverse trend (head up)
49
Obesity: Postop management before the pt is "light" what type of airway is good to use
nasal
50
Obesity: Postop management during extubation adequate pain control is often accompied w/ fuller deeper breaths, but narcs can hinder this in fatties, what is a better choice
ofirmev
51
Obesity: Postop management post intubation what is a good position for them
head up 30 degress and lateral decubitus
52
Thats it a special thanks goes out to Sam Tim
whatever were done,

BioScience II (39 decks)

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