Wk2 Obesity Flashcards
Is high BMI associated with breathing problems?
Yes
What is the limitations of using BMI for obesity assessment ?
Does not differentiate between fat mass & fat-free mass
Does not account for body fat distribution
What does waist-to-hip ratio assess?
Body fat distribution
what is the gold standard for body fat assessment?
Dural energy x-ray absorptiometry (DXA)
What is the most common cause of weight gain?
Primary weight gain: accumulation of adipose tissue that results from an imbalance between caloric intake and energy expenditure
What is secondary weight gain?
Accumulation of adipose tissue that results from genetic syndromes/other medical conditions/medication side effects
When to screen for gestational diabetes and how is it done?
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)
how to manage gestational diabetes?
diet & medication
What is this condition?
new onset of hypertension >140/>90 mmHg after 20 weeks of gestation with proteinuria/end-organ dysfunction
Pre-eclampsia
How to manage pre-eclampsia?
co-management with OBGYN (BP control and seizure prevention )
Delivery at wk37 or 34 if severe
What is the BMI cutoff range for gestational diabetes & pre-eclampsia?
Gestational diabetes: BMI>25
Pre-eclampsia: BMI>30
What is recommended weight gain in pregnancy for women BMI over 30?
Recommended total weight gain for pregnancy: 5-9kg
Weekly weight gain on average in 2nd & 3rd trimesters: 0.2kg per week
Is menopause a risk factor for weight gain?
yes
What are some red flags in obesity?
- 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
What is the waist circumference cutoff values?
35in for women
40in for men
Obesity significantly contribute to the prevalence of what most?
Type 2 diabetes (61%)
Uterine cancer (34%)
How is T2DM diagnosed?
fasting blood glucose >7 mmol/L
HbA1C >6.5%
How is the prognosis for T2DM?
15% higher mortality due to increased atherosclerotic cardiovascular disease
Obesity is a risk factor for which sleep problem?
Obstructive sleep apnea
45% prevalence in obese adults
How do you diagnose obstructive sleep apnea?
Polysomnography
- BMI
- neck circumference >40cm
- chin position
- narrow oropharyngeal opening
- gender/age
How to screen for obstructive sleep apnea?
STOP-Bang questionnaire
Snoring
Tiredness
Observed apnea
High BP
What is prevalence of NAFLD in obese adults?
80-90%
How do you diagnose NAFLD?
Ultrasound
Liver biopsy
ALT/AST=elevated or normal
What is the management for NAFLD?
weight loss:
Steatosis: 3-5%
NASH: 7-10%
How often do you check CBC and chemistry panel with iron level on postoperative follow-up for bariatric surgery?
each visit
How often do you check lipid level on postoperative follow-up for bariatric surgery?
every 6-12 months
How often do you check bone densitometry on postoperative follow-up for bariatric surgery?
every 2 years
How often do you check 24hr urinary excretion on postoperative follow-up for bariatric surgery?
yearly
initially after 6 months post-surgery
On postoperative follow-up for bariatric surgery, how often do you check VB12?
annually or every 3-6 months if supplemented
On postoperative follow-up for bariatric surgery, how often do you check VA?
every 6-12 months (BPD-DS)
What is the percentage of weigh loss is sufficient ?
5-10%
