Weight Gain And Loss

Question 1

Energy expenditure is determined by (2)

Answer 1

Basal metabolism requirements (~50% total calories. Remains constant in health)
PA (easily fluctuated, major impact on weight)

Question 2

Changes in body weight that are not deliberate may indicate presence of

Answer 2

Disease.

Unintentional weight loss

Question 3

Weight gain causes (4)

Answer 3

Excessive caloric intake
Fluid retention
Pregnancy
Endocrine disorder

Question 4

Weight gain of excessive caloric intake

Answer 4

Familial obesity: learned overeating

Emotional hyperphagia: stress, anxiety, depression

Question 5

Weight gain of fluid retention

Answer 5

Edema d/t: nephrotic syndrome, CHF, liver cirrhosis.
Premenstrual edema (transient and benign)
Salt retaining meds: steroids, NSAIDs (ibuprofen, naproxen), lithium compounds

Question 6

Weight of endocrinologic disoder

Answer 6

Cushing syndrome, hypothyroidism

Question 7

Symptoms of cushings

Answer 7

Flushed face, acne, buffalo hump, bruisability, immunosuppression, HTN, edema, osteoporosis, muscle wasting, hunger, insomnia, mental changes, truncal and facial obesity, thinning skin, gastric ulcers, hunger, HYPOKALEMIA, diabetes.
D/t pituitary adenoma, adrenal adenoma, iatrogenic
Natural diurnal rhythm: High cortisol AM, low PM. Best to workout AM.

Question 8

Hypothyroidism symptoms

Answer 8

Slow mind and body, weak heartbeat, constipation, myxedema, high LDL, slow reflexes, hair thinning, depression (schizophrenia), irritability, big tongue, croaky voice, dry skin, cold skin, cold intolerance

Question 9

Physical findings in the obese patient:

Answer 9

If increased caloric intake = usually evenly distributed. EXCEPT ABDOMINAL OBESITY, ASIAN POPULATION!!!
Endocrinologic obesity usually has a patterned fat distribution.
Truncal + buffalo hump = cushing; obesity + dry hair, coarse skin, hoarse voice = hypothyroidism

Question 10

Diagnostic tests for obesity

Answer 10

Biochemical profile + lipoproteins
Thyroid function tests
Cortisol