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37 Cards in this Set
- Front
- Back
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Obesity is classified as IBW greater than ____ or a BMI greater than ____?
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IBW above 20%
BMI >28 can be considered obsese |
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Overweight is classified as what?
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BMI 25-29.9 kg/m2
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Obesity is defined as a BMI greater than?
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30 kg/m2
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What is moderate, severe and morbid obesity's BMI?
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mod-30-34.9
severe-35-39.9 morbid- >40 |
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How do you calculate IBW for males and for females?
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males- Ht(cm)-100= IBW in Kg
females- Ht(cm)-105=IBW in kg |
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What are some prominent conditions in overweight and obsese patients?
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1.Type II DM 2. CAD 3. HTN
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If a person is morbidily obses how drugs are calculated by using ?
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IBW
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What is another name for central far distribution?
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"android" the apple shape
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Central fat is more common in whom?
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men
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Patients that have central fat distribution have what?
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1.increase abd and visceral fat
2.cental adipose more metab.active 3.Increase of metab. complications |
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What are some metabolic complications assoc. with central fat distribution?
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dyslipidemia,glucose intol.,DM, higher incidence of ischemic heart disease
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A higher proportion of visceral placed an increased risk from ?
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CV disease, LV dysfunction, stroke
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How is HTN defined?
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SBP >140 and DPB >90
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What are predisposing factors for Obstructive sleep apnea (OSA)?
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male, middle age, BMI>30
other factors: evening alcohol, night sedation |
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What happens to lung volumes in obsesity?
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Decrease in FRC, ERV and TLC
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What are some other factors that could help identify OSA?
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htn, observed sleep apnea,collar size >16.5, polycthemia, hypoxemia, hypercapnia, RV hypertrophy
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What is used in a sleep lab to diagnose OSA?
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polysomnography
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How is sleep apnea defined in terms of OSA?
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> 10 secs total cessation airflow with continuous effort against closed aireay
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How is hypoponea defined in terms of OSA?
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50% reduction in airflow or reduction sufficient to lead to 4% decrease in art o2 sat
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What are the clinical sequela associated with OSA episodes?
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hypoxia, hypercapnia, syst and pulm HTN, cardiac arrhythmias, chronic resp acidosis
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Manifestations of OSA include?
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snoring, daytime sleepiness, morning headaches
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Why would someone have a morning headache if OSA is suspected?
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caused by nocturnal CO2 retention and cerebral vasodilation
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What are some physiological manifestations of OSA?
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hypoxemia,hypercapnia, pulm and syst vasocont.,secondary polycythemia
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Secondary polycythemia in relation to OSA can cause?
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increased risk ischemic heart disease and cerebrovascular disease
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What does hypoxic pulmonary vasoconstriction lead to in relation to OSA?
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rt vent failure
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Alcohol and drugs can do what to the airway?
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decrease muscle tone and decreased further when sleeping
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Obesity hypoventilation leads to long-term consequences of what?
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central apnea, progressive desensitization to hypercapnia, leads to increase reliance on hypoxic drive for ventilation
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What are some features with obesity in relation to Pickwickian syndrome?
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daytime somnolence, hypoxia, hypercapnia, RVF, polycythemia, pulmonary HTN
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Excess wt on chest and increased intra-abd pressure produces?
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restrictive lung disease-like process
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In obesity the RV and the closing capacity remain unchanged what happens to CW complaince and other lung volumes?
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decrease, FRC,ERV,TLC,Vital capacity and Chest wall compliance decreases.
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Morbidly obese there is approx what amt of reduction in FRC?
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50% ;compared with a 20% fall in anesthetized nonobese subjects
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In the pulmonary system of obese patients there is a decrease FRC but and increase in what?
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O2 consumption
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What happens when PEEP is added to an obese patient?
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improves FRC and O2 but CO and O2 delivery is decreased b/c decrease in CO.
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What happens to myocardial O2 consumption and CO2 production?
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increases in both
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How is normocapnia maintained in Obese patients?
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increase in Minute Vent, they can compensate for a while.
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What are the expected changes is ABG's in obesity in relation to the pulm. system?
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decrease PaO2,Increase A-aO2 gradient, normal PaCO2, noraml Ph (norm. vent response to CO2)
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In obese HYPOVENTILATION syndrome what should you expect in terms of gases?
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increase PaCO2 and impaired response to CO2
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