simple 45- overweight Flashcards

1
Q

medical conditions which might predispose patients to secondary obesity

A

Cushing’s
Hypothyroidism
Hypogonadism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Ask about symptoms of medical conditions associated with obesity, including symptoms of cardiovascular disease.

A

Sleep apnea (snoring, fatigue, and morning HA)

Cardiovascular disease (chest pain or dyspnea)

Cerebrovascular disease (vision change, neuro deficits)

Peripheral vascular disease (claudication)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

xanthelasma

A

Plaques or nodules composed of lipid-laden histiocytes on eyelids

hypoercholestolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Findings of vascular disease:

A

Carotid bruits
Diminished peripheral pulses
Hypertension
Increased abdominal aortic size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

the diameter of a normal abdominal aorta should be less than

A

2 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

retinal hemorrhages with pale centers, typically seen in bacterial endocarditis

A

roth spots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Obesity Evaluation for Co-Existing Risk Factors

A

DM: HgbA1C or fasting blood glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

USPSTF strongly recommends screening for lipid disorders

A

men > 35 years old

women > 45 years old if they are at increased risk for coronary heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

There are four groups of patients who are most likely to benefit from statin therapy:

A

Current ASCVD

LDL cholesterol > 190 mg/dL

Diabetes (type 1 or 2) age 40-75 years

Estimated 10-year ASCVD risk by Pooled Cohort Equations > 7.5%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causes of Secondary Dyslipidemias

A

DM2: hypertriglyceridemia and low HDL cholesterol.

Cholestatic or obstructive liver disease, such as primary biliary cirrhosis: elevated total cholesterol levels.

Nephrotic syn: high serum total and LDL and triglyc.

Hypothyroidism: hypercholesterolemia and hypertriglyceridemia.

Acute hepatitis : hypertriglyceridemia.

Alcohol : hypertriglyceridemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

meds that can cause modest changes in lipids

A

Thiazide diuretics, beta blockers, and oral estrogens and protease inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

statin positive effects

A
stabilize existing plaques, decreasing the risk of plaque rupture and myocardial infarction
decrease CHD and all-cause mortality
decrease LDL by 18% to 55%
increase HDL by 5% to 15%
decrease triglycerides by 7% to 30%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Bile acid sequestrants, such as cholestyramine effects

A

modest lower LDL and raise HDL

but raise triglycerides

GI distress, constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Niacin effects

A

*increase HDL, modest LDL, tri decrease

flushing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

first-line therapy for reducing triglycerides

A

Fibric acid derivatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ezetimibe MOA

A

inhibits absorption of cholesterol at the intestinal brush border and increases cholesterol clearance.

decreases LDL

17
Q

moderate vs high dose of statin difference

A

Moderate: lower LDL cholesterol by 30- < 50%

High: lower LDL cholesterol by > 50%

18
Q

High intensity therapy is recommended for:

A

patients ≤ 75 years of age with clinical ASCVD and no safety concerns

those with LDL cholesterol > 190 mg/dL

diabetics aged 40-75 with estimated 10-year ASCVD risk of > 7.5%

19
Q

Moderate intensity therapy is recommended for:

A

patients > 75 years of age with clinical ACSVD

diabetics aged 40-75 with estimated 10-year ASCVD risk of < 7.5%

patients for whom high-dose therapy would be recommended but who are not candidates for high-intensity statins.

20
Q

What caloric deficit is needed to lose one pound of body weight?

A

3500 calories

21
Q

Oral drug therapy for obesity indications

A

All weight loss medications approved by the FDA are indicated for patients with BMI > 30;

most are also indicated for patients with BMI > 27 with at least one obesity-related comorbidity such as hypertension or diabetes.

22
Q

Phentermine
Diethylpropion
Pendimetrazine
Benzphetamine

A

Noradrenergic appetite suppressant

Indicated for short-term (a few weeks) only

23
Q

Orlistat MOA

A

Gastrointestinal lipase inhibitor

Decreases fat absorption

24
Q

Lorcaserin MOA

A

Highly selective serotonergic receptor agonist appetite suppressant

Associated with hypoglycemia in diabetic patients

25
Qsymia (combination of phentermine and topiramate) MOA
Acts via multiple pathways to suppress appetite
26
Contrave (naltrexone/bupropion)
for obesity
27
bariatric surgery indications
Patients with BMI > 40 or BMI ≥ 35 with associated severe health complications who have not succeeded in losing weight with other treatment methods.
28
bariatric surgery options
Gastric bypass-partitioning of the stomach with attachment of the proximal stomach to the jejunum Adjustable gastric banding-placement of an inflatable, adjustable band around the stomach Vertical banded gastroplasty-partial partitioning of the proximal stomach with placement of a small, fixed-diameter gastric outlet stoma