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26 Cards in this Set
- Front
- Back
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Obesity associated comorbidities |
Type 2 DM Cardiovascular dx HTN Stroke Breast & Colon CA Dyslipidiemia Infertility Asthma Chronic Back Pain Osteoarthritis Obstructive Sleep Apnea Erectile Dysfunction Impaired Immunity Gallbladder Dx |
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Underweight BMI |
less than 18.5 |
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normal weight |
between 18.5 - 24.9 |
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overweight |
between 25 - 29.9 |
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obesity |
30 - 34.9 |
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Diagnoses to consider in obese patients |
*hyperinsulinemia *hypothyroidism *polycystic ovary syndrome *binge eating disorder *eating disorder *hypothalamic obesity |
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success measurement (nonsurgical) associated with decreased risk of morbidity and mortality |
10% weight loss from beginning weight 7% loss kept off during maintenance |
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Bariatric surgery success |
>50% of excess body weight 80% loss off 3-5 years after loss stabilizes |
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Bariatric surgery Failure |
<50% of excess body weight |
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Bariatric Surgery Indications |
BMI> 40 with comorbidities failure of previous weight loss attempts excluding reversible endocrine cause of obesity ability to commit to post-op care |
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Bariatric Procedures |
LAGB gastric bypass |
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LAGB |
laprascopic adjustable gastric binding |
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Gastric bypass complications |
malabsorption nutritional deficiency Dumping syndrome (improves w. slow meals; avoid liquid with meals; avoid carbs) surgical leaks |
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Medications that have anorexia as side effect |
digoxin phenytoin SSRI calcium channel blocker H2 receptor antagonists PPIs Narcotics & NSAIDS furosemide potassium supplements Ipratropium theophylline |
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Factors that contribute to death in US |
improper nutrition inaduequate physical activity ineffective stress management |
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Healthy People 2020 individual behavior determinants of health |
diet physical activity alcohol cigarette & other drug use hand washing |
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CAGE lifestyle assessment |
cheese & other sources of dairy fats animal fats got it away from home extra high fat products candy, pastry, etc |
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Physical exam waist circumference high risk values |
men > 102 cm or 40 inches women > 89cm or 35 inches |
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Diagnostics for Obesity |
blood glucose Lipid profile (Triglycerides, total choleserol, HDL, LDL, VLDL) stress EKG bone density for postmenopasual women |
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CDC & AHA recommendation for exercise |
brisk walking 30-60 minutes 3 to 4 times week or 30 min for 5 days |
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Smoking Cessation 4 As counseled at every vist |
Ask - if want to quit Advise - to quit Assist - refer to group Arrange - follow up |
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Smoking Cessation Pharmacotherapy |
Most successful when combined with behavior modification or formal smoking cessation group |
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Individualized approach to smoking cessation: for motivated heavy smokers >15 cigarettes /day |
provide NRT and behavioral support consider adding bupropion & more support |
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Individualized approach to smoking cessation: for motivated heavy smokers >10 cigarettes /day |
provide NRT and behavioral support |
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Individualized approach to smoking cessation: for motivated light smokers |
advice refer to to formal cessation program |
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HTN treatment lifestyle modifications |
weight reduction adopt DASH eating plan Dietary sodium reduction physical activity moderation of alcohol consumption |
