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CMS 200 > Wk2 Obesity > Flashcards

Wk2 Obesity Flashcards

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Introductory Sommelier Exam (CMS) flashcards
1
Q

Is high BMI associated with breathing problems?

A

Yes

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2
Q

What is the limitations of using BMI for obesity assessment ?

A

Does not differentiate between fat mass & fat-free mass

Does not account for body fat distribution

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3
Q

What does waist-to-hip ratio assess?

A

Body fat distribution

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4
Q

what is the gold standard for body fat assessment?

A

Dural energy x-ray absorptiometry (DXA)

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5
Q

What is the most common cause of weight gain?

A

Primary weight gain: accumulation of adipose tissue that results from an imbalance between caloric intake and energy expenditure

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6
Q

What is secondary weight gain?

A

Accumulation of adipose tissue that results from genetic syndromes/other medical conditions/medication side effects

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7
Q

When to screen for gestational diabetes and how is it done?

A

Screening for gestational diabetes between 24-28 weeks of pregnancy using a two-step process.

  • 50g 1hour oral glucose challenge test (diagnosed if plasma glucose is over 11.1)
  • 75g oral glucose tolerance (if plasma glucose is between 7.8-1. Diagnosed if fating plasma glucose is over 5.3/ 1hr over 10.6 and 2hr over 9)
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8
Q

how to manage gestational diabetes?

A

diet & medication

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9
Q

What is this condition?

new onset of hypertension >140/>90 mmHg after 20 weeks of gestation with proteinuria/end-organ dysfunction

A

Pre-eclampsia

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10
Q

How to manage pre-eclampsia?

A

co-management with OBGYN (BP control and seizure prevention )

Delivery at wk37 or 34 if severe

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11
Q

What is the BMI cutoff range for gestational diabetes & pre-eclampsia?

A

Gestational diabetes: BMI>25

Pre-eclampsia: BMI>30

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12
Q

What is recommended weight gain in pregnancy for women BMI over 30?

A

Recommended total weight gain for pregnancy: 5-9kg

Weekly weight gain on average in 2nd & 3rd trimesters: 0.2kg per week

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13
Q

Is menopause a risk factor for weight gain?

A

yes

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14
Q

What are some red flags in obesity?

A
  • Rapid weight gain over days to weeks
  • difficulty breathing/coughing at night
  • inability to sleep laying flat
  • recent increase in waist or pant-size
  • yellowing of skin and whitening of eyes or tea-colored urine
  • prolonged bleeding
  • reduction in urination
  • N/V
  • Itching
  • feet/ankles/legs swelling
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15
Q

What is the waist circumference cutoff values?

A

35in for women
40in for men

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16
Q

Obesity significantly contribute to the prevalence of what most?

A

Type 2 diabetes (61%)
Uterine cancer (34%)

17
Q

How is T2DM diagnosed?

A

fasting blood glucose >7 mmol/L

HbA1C >6.5%

18
Q

How is the prognosis for T2DM?

A

15% higher mortality due to increased atherosclerotic cardiovascular disease

19
Q

Obesity is a risk factor for which sleep problem?

A

Obstructive sleep apnea

45% prevalence in obese adults

20
Q

How do you diagnose obstructive sleep apnea?

A

Polysomnography
- BMI
- neck circumference >40cm
- chin position
- narrow oropharyngeal opening
- gender/age

21
Q

How to screen for obstructive sleep apnea?

A

STOP-Bang questionnaire

Snoring
Tiredness
Observed apnea
High BP

22
Q

What is prevalence of NAFLD in obese adults?

A

80-90%

23
Q

How do you diagnose NAFLD?

A

Ultrasound
Liver biopsy

ALT/AST=elevated or normal

24
Q

What is the management for NAFLD?

A

weight loss:

Steatosis: 3-5%
NASH: 7-10%

25
Q

How often do you check CBC and chemistry panel with iron level on postoperative follow-up for bariatric surgery?

A

each visit

26
Q

How often do you check lipid level on postoperative follow-up for bariatric surgery?

A

every 6-12 months

27
Q

How often do you check bone densitometry on postoperative follow-up for bariatric surgery?

A

every 2 years

28
Q

How often do you check 24hr urinary excretion on postoperative follow-up for bariatric surgery?

A

yearly

initially after 6 months post-surgery

29
Q

On postoperative follow-up for bariatric surgery, how often do you check VB12?

A

annually or every 3-6 months if supplemented

30
Q

On postoperative follow-up for bariatric surgery, how often do you check VA?

A

every 6-12 months (BPD-DS)

31
Q

What is the percentage of weigh loss is sufficient ?

A

5-10%

CMS 200 (6 decks)

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