Term
|
Definition
conservative: diet exercise
medical
surgical |
|
|
Term
criteria for orlistat
it is given as part of an overall plan for managing obesity |
|
Definition
BMI 28 or more with associated risk factors (T2DM, hyperlipidaemia or HTN) or
BMI 30 or more
those with continued weightloss eg 5% at 3 months.
orlistat is usually used for <1 year |
|
|
Term
|
Definition
weight in kilograms divided by height in metres squared
eg 50kg/1.52^2 =20.54 |
|
|
Term
| a BMI is <18.5 is class as what? |
|
Definition
underweight
<18.5 = underweight
18.5-24.9 = normal
25-29.9 = overweight
30-34.4 = obese
35- 39.9 = clinically obese
> 40 morbidly obese |
|
|
Term
| what additional does NICE advice to supplement BMI in those with BMI <35? |
|
Definition
|
|
Term
| in elderly patient which BMI group has the lowest morbidity? |
|
Definition
25-30 ratherthan 20-25
in young adults 25 is classed as over weight |
|
|
Term
| waist circumference bands for men |
|
Definition
>102 is very high risk
<94 is normal
anything between these values is high risk |
|
|
Term
| waist circumference bands for women |
|
Definition
<80 is normal
> 88cm is very high risk and any reading in between these values is high risk |
|
|
Term
| which gene has recently been identified and implicated in obesity and metabolic rate? |
|
Definition
|
|
Term
|
Definition
FHx
lifestyle
diet
socioeconomic factors
deprivation
lower level of education |
|
|
Term
| medications that can aggravate weight gain |
|
Definition
sulfonylureas and thiazilidonidiones
TCA and mirtazapine
sodium valproate
atypical antipsychotics
lithium
steroids
beta blocker
progesterone only injection |
|
|
Term
| conditions that can aggravate weight gain |
|
Definition
hypothyroid
cushings
GH deficiency
PCOS
hypothalamic damage |
|
|
Term
| when was the department of health document called ' a call to action on obesity in England' published? |
|
Definition
|
|
Term
| which one costs the NHS more money? obesity or smoking? |
|
Definition
|
|
Term
|
Definition
increased risk of hypoventilation, copd, sleep apnoea
increased risk of breast and endometrial and colon cancer
osteoarthritis
stress incontinence
fatty liver
metabolic syndrome
type II diabetes |
|
|
Term
| how many calorie deficit diets do the NICE 2014 recommend? |
|
Definition
|
|
Term
|
Definition
120mg TDS max
miss dose if your meal contains no fat |
|
|
Term
| NICE 2014 criteria for bariatric surgery |
|
Definition
BMI 40 or more or 35 with significant comorbidities that would be improved if they lost weight
all non surgical measures have been tried to insufficient or max effect
person is under intensive mx of a specialist team
person is fit for anaesthesia/surgery
the person commits to the need for long term follow up. this is at least 2 years follow up with the specialist team |
|
|
Term
| which organisation was set up in a effort to collate research on obesity? |
|
Definition
| The National Obesity Obseratory |
|
|
Term
| what is an average water requirement? |
|
Definition
| 1.5 - 2 litres. this is 6-8 cups of water a day |
|
|
Term
average protein, carbohydrate and fat requirement for adult?
1g protein = 4 calories
1g fat = 9 calories
1g carbohydrate = 3.75, rounded to 4calories
fibre - 2 calories per gram |
|
Definition
protein 56g/day men 46g/day women
50% of our energy should come from starchy carbohydrates
11% energy from fats |
|
|
Term
| name the essential8 amino acids |
|
Definition
lysine
leucine
isoleucine
valine
methionine
phenylalanine
tryptophan
threonine |
|
|
Term
| how much energy shold we be getting from carbs, protein and fats? |
|
Definition
|
|
Term
| average daily energy requirements for men and women? |
|
Definition
men 2500 calories per day
women 2000 calories per day |
|
|
Term
| alcohol should not provide > how much of a person energy intake daily? |
|
Definition
| should not be >5% of daily energy intake |
|
|
Term
| recommend allowance of fibre daily? |
|
Definition
18g in adults
less in children |
|
|
Term
| what abnormal blood result and lipid profiles would you get with anorexia nervosa? |
|
Definition
hypokalemia
raised cortisol
raised cholesterol
raised aminotransferases
elevated CK
hypoglycaemia
hyponatremia
metabolic alkalosis if persistent vomiting
urea and creatinine can be low |
|
|
Term
| causes of anorexia nervosa |
|
Definition
social causes: western world
job: models, dancers, jockeys
pressures: bullying, puberty, family
psychological: way to exert control |
|
|
Term
what does SCOFF stand for?
2 or more positive answers should prompt a more detailed history |
|
Definition
Sick - do you feel uncomfortably sick when eating
Control - do you worry you have none over food
One stone loss in 3 months?
Fat - you think youre fat when others say youre thin
Food dominates your life? |
|
|
Term
|
Definition
| bradycardia prolonged QT interval |
|
|
Term
|
Definition
|
|
Term
| physiological abnormalities in anorexia nervosa from passmed |
|
Definition
hypokalemia
low fsh, lh, oestrogen and testosterone
raised cortisol and GH
hypercholesterol
hypercarotinaemia
impaired glucose tolerance
low t3 |
|
|
Term
| how long is an NG tube suitable for feeding? |
|
Definition
|
|
Term
| how do NICE define malnutrition? |
|
Definition
BMI <18.5 or
unintentional weightloss >10% in the last 3-6 months OR
BMI <20 and unintentional weight loss >5 % in last 3-6 months |
|
|
Term
| how to check NG tube placement? |
|
Definition
aspiration and Ph check
AXR for those tubes placed past the pyloric tubes |
|
|
Term
| which malnutrition disease occurs in developing countries and is associated with oedema and hepatomegaly? |
|
Definition
kwashiokoorrrr look at your oedema
it has O in the spelling for oedema |
|
|
Term
| what signs would you see in a child with marasmus? |
|
Definition
severe wasting
due to inadequate protein intake |
|
|
Term
| who should nutritional support be considered for? ie what is the criteria for malnutrition and who is at increased risk? |
|
Definition
BMI <18.5
unintentional weight loss of >10% in past 3-6 months
BMI <20 and unintentional weight loss >5% in last 3-6 months
those who have eaten little or nothing for >5 days and are unlikely to be eating more for the next 5 days
those with poor absorption, high nutrient losses or increased nutrient needs. |
|
|
Term
when does refeeding syndrome start?
which electrolyte disturbance is evident in re feeding syndrome? |
|
Definition
usually within 4 days of initiating re feeding
hypophosphateamia is evident in re feeding syndrome. |
|
|
Term
| when the body is not starving it uses carbohydrates but when in starvation mode which fuels does it switch to? |
|
Definition
fats and amino acids.
insulin secretion suppressed and glucagon secretion increased |
|
|
Term
| what is the common cause of death from refeeding syndrome? |
|
Definition
|
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