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37 Cards in this Set

  • Front
  • Back
Obesity is classified as IBW greater than ____ or a BMI greater than ____?
IBW above 20%
BMI >28 can be considered obsese
Overweight is classified as what?
BMI 25-29.9 kg/m2
Obesity is defined as a BMI greater than?
30 kg/m2
What is moderate, severe and morbid obesity's BMI?
morbid- >40
How do you calculate IBW for males and for females?
males- Ht(cm)-100= IBW in Kg
females- Ht(cm)-105=IBW in kg
What are some prominent conditions in overweight and obsese patients?
1.Type II DM 2. CAD 3. HTN
If a person is morbidily obses how drugs are calculated by using ?
What is another name for central far distribution?
"android" the apple shape
Central fat is more common in whom?
Patients that have central fat distribution have what?
1.increase abd and visceral fat
2.cental adipose more
3.Increase of metab. complications
What are some metabolic complications assoc. with central fat distribution?
dyslipidemia,glucose intol.,DM, higher incidence of ischemic heart disease
A higher proportion of visceral placed an increased risk from ?
CV disease, LV dysfunction, stroke
How is HTN defined?
SBP >140 and DPB >90
What are predisposing factors for Obstructive sleep apnea (OSA)?
male, middle age, BMI>30
other factors:
evening alcohol, night sedation
What happens to lung volumes in obsesity?
Decrease in FRC, ERV and TLC
What are some other factors that could help identify OSA?
htn, observed sleep apnea,collar size >16.5, polycthemia, hypoxemia, hypercapnia, RV hypertrophy
What is used in a sleep lab to diagnose OSA?
How is sleep apnea defined in terms of OSA?
> 10 secs total cessation airflow with continuous effort against closed aireay
How is hypoponea defined in terms of OSA?
50% reduction in airflow or reduction sufficient to lead to 4% decrease in art o2 sat
What are the clinical sequela associated with OSA episodes?
hypoxia, hypercapnia, syst and pulm HTN, cardiac arrhythmias, chronic resp acidosis
Manifestations of OSA include?
snoring, daytime sleepiness, morning headaches
Why would someone have a morning headache if OSA is suspected?
caused by nocturnal CO2 retention and cerebral vasodilation
What are some physiological manifestations of OSA?
hypoxemia,hypercapnia, pulm and syst vasocont.,secondary polycythemia
Secondary polycythemia in relation to OSA can cause?
increased risk ischemic heart disease and cerebrovascular disease
What does hypoxic pulmonary vasoconstriction lead to in relation to OSA?
rt vent failure
Alcohol and drugs can do what to the airway?
decrease muscle tone and decreased further when sleeping
Obesity hypoventilation leads to long-term consequences of what?
central apnea, progressive desensitization to hypercapnia, leads to increase reliance on hypoxic drive for ventilation
What are some features with obesity in relation to Pickwickian syndrome?
daytime somnolence, hypoxia, hypercapnia, RVF, polycythemia, pulmonary HTN
Excess wt on chest and increased intra-abd pressure produces?
restrictive lung disease-like process
In obesity the RV and the closing capacity remain unchanged what happens to CW complaince and other lung volumes?
decrease, FRC,ERV,TLC,Vital capacity and Chest wall compliance decreases.
Morbidly obese there is approx what amt of reduction in FRC?
50% ;compared with a 20% fall in anesthetized nonobese subjects
In the pulmonary system of obese patients there is a decrease FRC but and increase in what?
O2 consumption
What happens when PEEP is added to an obese patient?
improves FRC and O2 but CO and O2 delivery is decreased b/c decrease in CO.
What happens to myocardial O2 consumption and CO2 production?
increases in both
How is normocapnia maintained in Obese patients?
increase in Minute Vent, they can compensate for a while.
What are the expected changes is ABG's in obesity in relation to the pulm. system?
decrease PaO2,Increase A-aO2 gradient, normal PaCO2, noraml Ph (norm. vent response to CO2)
In obese HYPOVENTILATION syndrome what should you expect in terms of gases?
increase PaCO2 and impaired response to CO2