Harman hints test #1 fat asses Flashcards

per Harmans help

1
Q

BMI formula

A

weight (in kg) / height (in meters)^2
or
weight (lbs) / Height (inches^2) x 703

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2
Q

side note how many inches in 1 meter (for BMI conversion)

A

0.0254

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3
Q

Calculate BMI using either or both formulas for 6’9” man who weight 300lbs (round it off JAKE)

A
300lbs=136kg
6'9"= 81 inches (6,561 inches^2)
81 inches= 2.0574 meters (4.2 meters ^2)
ok so....
136kg/4.2m^2=32.3 kg/m^2 
or 300lbs / 6,562 inches^2 x 703 = 32.1
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4
Q
BMI ranges
under weight
Normal
overweight
obese I
obese II
extremly obese III
superobese
super-super obese
A
under weight- < 18.5
Normal- 18.5-24.9
overweight- 25-29.9
obese I- 30-34.9
obese II- 35-39.9
extremly obese III- > 40
superobese- >50
super-super obese- > 60
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5
Q

IBW formulas

A

MEN:
height (cm) - 100
WOMEN:
Height (cm) - 105

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6
Q

side note how many cm in an inch

A
  1. 54cm

* **(so for IBW use 2.54 conversion for inches to cm and for BMI use 0.0254 for inches to meters)

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7
Q

calculate IBW
MAN- 18’9”
WOMAN- 5’8”

A
man
18'9"= 225inches=571.5 cm
so 571.5-100= 471 kg
woman
5'8"=68 inches=172.72cm
so 172.72cm-105=67.72kg
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8
Q

how is IBW recorded

A

Kg

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9
Q

what % of U.S. adults are overweight or obese

A

65%

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10
Q

what % of U.S. adults are obese

A

30%

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11
Q

re-read N&P pg 1036 aspiration prophylaxis and consider inLMA is ALWAYS contraindicatedbin obese pt?

A

-it is known GERD and hiatal hernia are more prevalent in the obese, and this may predispose them to esophagitis and pulmonaryaspiration
- More recent data, howver, have demonstrated that obese pts (BMI > 30) may have lower incidence of “at rrisk” stomach contents compared to lean pts
-in one study researchers evaluated gastric contents of 232 surgical pts. only 20 of 75 (27%) had high, volume, low PH stomach contnets, compared to 66 of 157 (42%) of lean pts
-more recent studies have also demonstrated that obese pt’s who are fasting may not have gastric PH and volumes that would put them at risk for Pulmonary aspiration.
-there is no concensus on wheter obese pts have delayed, normal, or accelerated gastric emptying
-obesity is significantly r/t GERD
-More recent and favorable data, some advocate the ovoidance of RSI on obese pt’s as standard of care
SO I WOULD SAY NO

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12
Q

indications for bariatric sx

A

u have dieted and failed

  • BMI > 40
  • BMI >35 and have serious health conditions associated with your obesity (DM, HTN, Depression, heart disease, OSA)
  • more than 100lbs over IBW
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13
Q

3 types of bariatric sx’s

A

restricive
combined restrictive and malabsorptive
malabsorptive

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14
Q

3 types of restrictive procedures

A

LAP band
Sleeve gastrectomy
Verticle banded gastroplasty

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15
Q

1 ex of combined restrictive and malabsorptive procedures

A

Roux-en-Y gastric bypass

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16
Q

1 ex of malabsorptive procedure

A

biliopancreatic Diverson with duodenal switch

17
Q

Long term risk of gastric bypass

A

weight regain
anemia
vit/min deficiency
ETOH use d/o

18
Q

short term risk of gastric bypass

A
Hair loss
Kidney stones
N/V
Gallstones
hernia/ SBO/LBO
periphreal neuropathy
19
Q

Complications with bariatric sx

A
dumping syndrome
cholelithiasis
PE/DVT
anastomotic leak
GJ stricture
20
Q

Complications unique to AGB procedure

A
port disconnection/rupture
port displacement with stomach slippage
band rupture/erosion
port blockage/infection
tube related malfunction
21
Q

Benefits of gastric sx

A
reversing metabolic syndrome
decreased bp
decreased trig;ycerides
improves OSA/OHS
improves 
    -Nonalcoholic liver disease
    -GERD
    -Incontinence
    -polycystic ovarian syndrome
    -venous stasis
    -DJD
cure DM
Improves endocrine system
22
Q

Unique thing about gastric sx and DM

A

it can actually improve or cure DM even B4 weight loss

23
Q

expected weight loss of sx (of excess body weight only)

A

AGB-25-80%
Sleeve- 65-75%
Rouex-en-Y 50-70%