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Pediatric EOR exam > Peds Obesity > Flashcards

Peds Obesity Flashcards

1
Q

AAP suggests exclusive breastfeeding until how old

A

6 months

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2
Q

when should you wean a baby off breastfeeding ?

A

1 year old

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3
Q

what are advantages of breastfeeding

A
  • emotional connection
  • less illnesses for baby
  • reduces SIDS
  • reduces obesity
  • decreased risk of postpartum hemorrhage
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4
Q

what are disadvantages of breastfeeding

A
  • maternal fatigue
  • special diets
  • pain
  • latching issues
  • vitamin D supplementation
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5
Q

infants lose up to (…) of their birth weight

A

7%

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6
Q

when should the birth weight be regained?

A

10-14 days of age

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7
Q

follow up newborn exam should be performed in office (…) after birth

A

3-5 days

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8
Q

infants must gain (…) per day

A

15 grams

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9
Q

(…) fed infants grow more rapidly at 3-4 months

A

formula

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10
Q

what is the theory of childhood obesity in formula fed babies

A
  • formula fed babies are on scheduled feeds and finish the whole bottle
  • breast fed babies feed when they are hungry and stop when they are full
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11
Q

t/f no supplementation is needed in formula fed babies

A

true

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12
Q

when can you introduce single grain rice cereal?

A

4 month

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13
Q

when can you introduce baby foods?

A

6 months

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14
Q

when can you introduce meats?

A

9 months

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15
Q

why should you wait longer to introduce meats?

A

increases risk of diabetes

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16
Q

how does a baby show readiness for complementary foods?

A
  • able to hold head up
  • able to sit unassisted
  • brings objects to mouth showing interest in foods
  • ability to track spoon and open the mouth
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17
Q

purpose of introducing rice grain to diet?

A

adds additional iron

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18
Q

if single grain cereals are tolerated, you can introduce (…) in later weeks

A

mixed cereals

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19
Q

whole cows milk is introduced at (…)

A

12 months

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20
Q

milk consumption is limited to (…)

A

16oz/day

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21
Q

whole milk can be given until (…)

A

2 years

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22
Q

toddlers should try foods (….) before they decide they dont like it

A

10 times

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23
Q

you can give 1/2 a Flinstone vitamins at (…)

A

18 months

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24
Q

t/f you should not reward children with food

A

true

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25
Q

carbs should be (…) of the daily calories

A

55-60%

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26
Q

(…) of grains should be whole grains

A

1/2

27
Q

fats should be (…) of total calories

A

<30%

28
Q

if 1 parent is obese, there is a (…) in risk of obesity for the child, and (….) if both parents are obese

A

3x for 1 parent
15x for both parents

29
Q

(…) bedtimes are correlated to childhood obesity

A

later

30
Q

what is leptin

A

A hormone produced by adipose (fat) cells that acts as a satiety factor in regulating appetite.

31
Q

what is ghrelin

A

hormone secreted by the stomach that triggers feelings of hunger

32
Q

what meds are associated with obesity

A
  • steroids
  • sulfolylureas
  • OCPs
  • antidepressants
  • antipsychotics
33
Q

hormone levels in obesity:
-leptin
-estrogen
-cortisol
-GH
-insulin
-testosterone

A
  • leptin: increased
  • estrogen: increased
  • cortisol: increased
  • GH: decreased
  • insulin: resistance
  • testosterone in men: decreased
  • testosterone in women: increased
34
Q

GH and growth in obese children

A

grow rapidly at first and the GH drops so obese children have stunted growth

35
Q

organ systems and associated problems with obesity
-cardio
-resp
-ortho
-GI
-GU
-psych
-growth
-CNS
-skin

A
  • cardio: HTN
  • resp: asthma , OSA
  • ortho: joint pain
  • GI: reflux
  • GU: menstrual irregularities, micropenis
  • psych: anxiety and depression
  • growth: stunted
  • CNS: pseudotumor cerebri
  • skin: acanthosis nigricans
36
Q

diagnosis of childhood obesity

A
  • BMI chart
  • history of diet and exercise
  • PE
  • labs
37
Q

pertinent history questions for obese children

A
  • diet and exercise
  • screen time
  • family history
  • associated symptoms
  • medications
38
Q

diagnosis of HTN in child

A

3 or more elevated reading on 3 different occasions at least 1 week apart

39
Q

t/f acanthothis nigricans can improve when glucose levels normalize

A

true

40
Q

barriers for providers in childhood obesity

A
  • time constraints
  • lack of knowledge in current recommendations
  • lack of patient motivation
  • communication barriers
41
Q

how to approach childhood obesity

A
  • avoid using words like obese, thick, fat, overweight
  • instead use excess weight, elevated BMI
42
Q

cholesterol screening recommendations for children

A
  • all children between 9 and 11
  • should be screened between 2 and 10 if they have FH of blood vessel disease, FH of elevated cholesterol, and any child with heart disease, diabetes, HTN, or are obese
43
Q

treatment of childhood obesity

A
  • dietary modifications
  • sleep modifications
  • exercise modifications
  • accountability
  • treat underlying disease
44
Q

diet modifications for childhood obesity

A
  • 5 fruits and vegges per day
  • eat breakfast
  • limit fast food and soda
  • eat as a family
45
Q

t/f diet drinks have been shown to have more associated weight gain than regular soda

A

true

46
Q

4 golden rules of eating

A
  • divide responsibilities
  • eat when your body is hungry
  • dont make children clean the plate
  • eat together
47
Q

effects of lack of sleep

A
  • increase ghrelin
  • decrease leptin
  • increase cortisol
  • increase insulin resistance
48
Q

exercise modifications for childhood obesity

A
  • join a sporting activity
  • exercise together
  • limit TV/electronics to under 2 hours per day
49
Q

mental health and childhood obesity

A
  • increased stress
  • increased anxiety and depression
  • increased suicide attempts
50
Q

medication management of childhood obesity

A
  • topamax
  • phentermine
  • qsymia
51
Q

stipulations for most bariatric surgeries

A
  • over 15 yo
  • BMI over 40 or 100% IBW
52
Q

MC surgical option for childhood obesity

A

gastric bypass

53
Q

normal vitamin d intake

A

600 U/day

54
Q

if vit D is 20-29…

A

OTC vitamin D3 1000U/d and recheck every 3 months

55
Q

if vit D is under 20…

A

Rx vitamin D2 50,000 U/weekly and recheck in 3 months

56
Q

what patients should you consider PCOS in?

A

hirsutism, acne, oliguria, elevated testosterone

57
Q

what patients should you consider kleinfelter in?

A

tall, hypogonadism, decreased testosterone

58
Q

Prader-Willi Syndrome

A

loss of paternally expressed genes

59
Q

MC syndromic form of obesity

A

Prader-Willi syndrome

60
Q

s/s of prader-willi

A
  • hyperphagia
  • short stature and GH deficiency
  • resistant to diet and exercise
61
Q

major criteria for prader willi syndrome

A
  • hypotonia
  • feeding issues
  • hypogonadism
  • facial abnormalities
  • developmental delay
  • hyperphagia
  • excessive weight gain
62
Q

follow up for pediatric obesity

A

assess BMI and vitals every 1-3 months

63
Q

if there has been no change in weight after 3-6 months of interventions…

A

consider referral to weight loss specialist or dietitian

Pediatric EOR exam (20 decks)

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