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Family Medicine - Lifestyle Modification
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41
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Graduate
07/02/2011

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Term
What is the dosage, s/e, cautions with the following tobacco dependence treatment option?

buproppion SR
Definition
1) 150mg qam (days 1-3); 150mg BID (day3+); use 1-2wks prior to quit date for 2-6mo
2) insomnia, dry mouth
3) seizure risk, MAOi concurrent use, eating disorder
2)
Term
What is the dosage, s/e, cautions with the following tobacco dependence treatment option?

nicotine gum
Definition
1) 2mg (0-24cig/d); 4mg (25+cigs/day); 1piece q1hr; up to 12weeks
2) mouth soreness, stomach ache
3) no food/drink 15minutes prior/during use
Term
What is the dosage, s/e, cautions with the following tobacco dependence treatment option?

nicotine inhaler
Definition
1) 6-16cartridges/d (80inhales/cartridge); up to 6mo w/ taper
2) local irritation of mouth and throat
3) may irritate mouth/throat at first (improves w/ use)
Term
What is the dosage, s/e, cautions with the following tobacco dependence treatment option?

nicotine lozenge
Definition
1) 2mg (30+min after waking first cig); 4mg (0-30min after waking); 1lozenge q1hr w/ taper; 3-6mo total
2) hiccups, cough, heartburn
3) no food/drink 15minutes before or during use
Term
What is the dosage, s/e, cautions with the following tobacco dependence treatment option?

nicotine nasal spray
Definition
1) 1dose/hr; 3-6mo total
2) nasal irritation
3) not for asthma patients, irritation of nose, dependence
Term
What is the dosage, s/e, cautions with the following tobacco dependence treatment option?

nicotine patch
Definition
1) 1 patch/d
2) local skin reaction; insomnia
3) not for eczema/psoriasis
Term
What is the dosage, s/e, cautions with the following tobacco dependence treatment option?

varenicline
Definition
1) 0.5mg qam (days1-3); 0.5mg BID (days 4-7); 1mg BID (days7+); start 1wk prior to quit; use 3-6mo
2) nausea, insomnia, abnl dreams
3) renal impairment/psychiatric illness use w/ caution
Term
What is the most important contraindication for use of metformin?
Definition
1) severe renal dysfunction (GFR<30)
Term
What is the use of bromocriptine mesylate in T2DM?
Definition
- monotherapy or adjunctive therapy to sulfonylurea/insulin
- reduces HbA2c levels
- not for nursing women or those receiving ergot alkaloids
Term
What is an example of a triple oral therapy for pts w poor control of double therapy
Definition
1) metformin, pioglitazone and a sulfonylurea
Term
What are the major forms of intimate partner violence that should be considered
Definition
- psychological
- physical
- sexual
- economic
Term
What is a "spiritual abuser
Definition
- raising mutual children in a religion that the victim is not in favor of
Term
What is the frequency of physical dating violence in youth?
Definition
1) 15% grades 7-12
2) 20% have psychological dating violence
Term
What are the major components to the "cycle of violence"
Definition
1) tension-builing stage
2) explosive stage
- tranquility/honeymoon stage
Term
Describe teh tranquility stage of the cycle of violence
Definition
- usually characterized byt he abuser seeming to be quite remorseful and apologetic for the abuse, making promises that it will never happen again and showering the victim with affection
Term
Define: infibulation
Definition
- fastening or bucking together, as in binding of feet, or of the female genitalia in an effort to render less able to walk or render unable to have seuxal intercourse, respectively
Term
What is the effect of IPV on homeless rates
Definition
- 25-50% of families have lost their homes as a result of IPV
Term
What are risk factors for female victimization in domestic violence
Definition
1) those w/ M partners who:
- abuse drugs
- unemployment/underemployment
- low education level
- have been in a romantic relationship w/ victim
- unmarried
- childhood in household w/ domestic abuse
Term
What is the most essential part of treating domestic abuse
Definition
- getting and keeping the victim of violence safe, including children
Term
What is the important fact regarding serving an abuser with a protective order?
Definition
1) abusers sometimes escalate in their abusiveness when first served w/ appropriate legal action; must take increased safety precautions
Term
What is the Duluth Model/Domestic Abuse Intervention Project?
Definition
1) approach to treating domestic abuse
- empowering victimized women w/ information, resources, and support
- uses legal resources and helps deliver consequences to male batterers
Term
What is the utility of the Violence Against Women Act?
Definition
- renewed in 2000
- significant prison terms and fines of up to more than 200k
Term
What are warning signs for persons outside the abusive relationship, that abuse may be occurring?
Definition
- absences from school/work
- numerous injuries the victim tries to explain
- low self-esteem
- change in personality
- fear of conflicts
- passive-aggressive behavior
- blaming him/her-self
- isolation from others
- stress-related physical symptoms
Term
What is the effect of IPV on children?
Definition
- greater risk of:
- psychiatric disorder
- developmental problems
- school failure
- violence against others
- low self-esteem
Term
What ethnicity reports more IPV than other ethnicities
Definition
1) american Indian/Alaska Native women and men
Term
What percent of female murder victims were killed by husbands/boyfriends?
Definition
1) 40-70%
2) "frequently in the context of an ongoing abusive relationship"
Term
What is the difference between risk factor and vulnerability factor in IPV discussion?
Definition
1) risk factor is anything that increases the likelihood that a person will COMMIT IPV
2) vulnerability facor is anything that icnreases the likelihood that a person will be the VICTIM of IPV
Term
What are risk factors for perpetrating IPV
Definition
1) Individual: young, low self-esteem, low income, loc academic achievement, alcohol/drug use, witnessed violence as child, unemployment
2) relationship factors: marital conflict/instability, male dominance, belief in stric gender roles, power hungry
3) community factors: poverty, low social capital, overcrowding, stress, weak sanctions against IPV
Term
What are the major vulnerability factors for victimization?
Definition
1) Individual: hx of physical abuse, verbally abusive partner, economic stress, childhood abuse, being under 24y/o
2) Relationship factors: marital conflict, male dominance, poor family fxn

*essentially the "same" as risk factors for perpetration*
Term
Describe the use of Sibutramine in weight loss
Definition
- acts centrallky to inhibit serotonin and norepinephrine reuptake and increase satiety
- may inc BP
- 6-8kg lost
Term
What are the major key points of all fad diets?
Definition
1) avoid trans-fatty acids/partially hydrogenated fats (decrease personal shelf life)
2) consum omega3s every day
- eat fewer bad carbs
- eat more good carbs
- calories count
- what you include is as important as what you exclude
- lower weight in a way that enhances health rather than harms it
- energy balance is important
- exercise more
- eat less red meat
- begin by making moderate changes in diet
- talk to suppliers
- choose quality
Term
What is the net dietary change promoted by the following fad diet:

aktins
ornish
south beach
the zone
Definition
1) low carbs, high protein, high fat
2) low fat, high fiber
3) moderate carb; moderate fat
4) low carb, high protein, moderate fat
Term
What is the basic regime promoted by the following diet:

atkins
Definition
1) Phase I: promotes ketosis, curbing appetite, carb intake is limited to 20net grams/d (2 weeks)
2) Phage II: increased carb intake to 15-60g
3) Phase III: carbs to 25-90g/d w/o gaining weight
4) Phase IV: carry on learned habits
Term
What is the basic regime promoted by the following diet:

ornish
Definition
1) meat and fish are not allowed
- emphasizes complex carbs, limits simple carbs
- very low in fat
- consuming nutrient dense, fiber-rich plant foods as desired causes major reduction in calorie and fat intake
- eating 3meals w/ 1-2 snacks daily regulates blood sugar and insulin
- regular exercise and stress reduction are key components
Term
What is the basic regime promoted by the following diet:

south beach
Definition
1) phase I: eliminates sugar cravings for 2wks; emphasis on vegetable and lean animal protein; all carbs are avoided
2) Phase II: long term weight loss; carbs re-introduced into diet (only good kinds)
- Phase III: maintains desired weight loss by continuing learned habits
- health snacking 1-2x/d is encouraged
Term
What is the basic regime promoted by the following diet:

the zone
Definition
1) carbohydrate intake of 40% stabilizes insulin le3vels and avoids weight gain
- protein intake of 30% is necessary for correct insulin/glucagons ratio for optimum weight loss
- fat intake of 30% for satiety
Term
What are the nutrition issues caused by the following fad diet:

atkins
Definition
1) long-term ketosis
- inadequate vitamin and mineral intake
- excessive protein intake creating health problems for patients
- very low fiber content causes constipation, colon cancer
Term
What are the nutrition issues caused by the following fad diet:

ornish
Definition
- potential for essential fatty acid deficiency
- potential for inadequate calcium/vitamin D
- possible GI distress due to high fiber content
Term
What are the nutrition issues caused by the following fad diet:

south beach
Definition
- exclusion of fruit and certain vegetables may be less beneficial given overal nutritional content
Term
What are the nutrition issues caused by the following fad diet:

the zone
Definition
- weight loss due to low calorie intake
- potential health issues include increased protein intake, decreased kidney function in DM,; osteoporosis
- original research on hormonal balance done with DM swimmers
Term
What are the components of the REAL principles of motivational interviewing?
Definition
1) Righting Reflex: don't lecture/correct; allow to express
2) Empathy: builds trust if reflective and open ended
3) Ambivalence: uncover discrepancy through active listening
4) Listen (and empower): pt must own the plan in order to effectively execute it
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