Final Exam: NR 577 (NR577) Primary Care Management of Adolescents and Adults Final Exam Review| Guide with Verified Answers| Latest 2023/ 2024| Chamberlain

Final Exam: NR 577 (NR577) Primary Care Management of Adolescents and Adults Final Exam Review| Guide with Verified Answers| Latest 2023/ 2024| Chamberlain QUESTION Onychomycosis Answer: nails are only area involved QUESTION Eczema Answer: itchy ozzy crusted lesion. The itch before the rash QUESTION Lichen planus Answer: thick non-scaly lesions limited to wrists limbs and oral mucosa QUESTION Risks of obesity Answer: HTN, Dyslipidemia, DM2, Coronary heart disease, stroke, gallbaldder disease, OA, sleep apnea, Cancer, PCOS, mental health, eating dis- orders, generalized pain QUESTION BMI Answer: Underweight 18.5 Normal 18.5-24.9 Overweight: 25-29.9 Obese: 30 - 24.9 Extremely Obese: 35 QUESTION Physical exam for obesity Answer: possible secondary causes (thyroid disease, adren- al disorder, etc.) possible complications of obesity (DM, CVD, PVD, etc.) BMI waist/hip circumference—measurement of visceral fat neck circumference—due to risk of OSA obesity associate skin disorders—candida rashes, hirsutism, acanthosis nigricans, skin tags, striae, and pressure ulcers respiratory—decreased breath sounds secondary to obesity hypoventilation cardiac—murmur associated with heart failure abdominal—RUQ pain, Murphy's sign (higher incidence in gallbladder issues and fatty liver) musculoskeletal—OA psychological—depression (use Patient Health Questionnaire PHQ-9 screening tool) QUESTION Dx testing for obesity Answer: TSH, HbA1C, lipid panel, LFT, BUN, Uric Acid, Vt D, CBC, Urine microalbumin, EKG Becasue:All the tests listed should be performed to rule out secondary causes of obesity. Risk factors associated with obesity should be assessed, especially those associated with coronary artery disease such as hyperlipidemia, insulin resistance, type 2 diabetes. QUESTION Differential dx for obesity Answer: hypothyroidism Cushing's syndrome hypothalamic injury mesomorphism (bodybuilders, wrestlers) genetic diseases: Prader Willi or Pickwickian syndrome. QUESTION Tx obesity Answer: Diet, physical activity, behavior modification, Pharmacological man- agement QUESTION Orlistat Answer: blocks absorption of fat in GI tract QUESTION Lorcaserin Answer: selective serotonin 5-HT2C agonists reduces appetite QUESTION Phentermine Answer: suppresses appetite, stimulant Rx QUESTION Naltrexone-bupropion Answer: unknown mechansim QUESTION Ozempic, Trulicity, wegovy Answer: GLP-1 medications QUESTION Surgical interventions for obesity Answer: lap band vertical sleeve gastrectomy Roux-en-Y gastric bypass duodenal switch QUESTION Bariatric surgery Answer: should be reserved for those patients with a BMI over 40kg/m2 without comorbidities OR over 35kg/m2 with comorbid condition QUESTION Adolescent obesity Answer: increases the individual's risk for acute physical and psychological health concerns, including early signs of type II diabetes, asthma, sleep apnea, fatty liver, low self-esteem, and being at greater risk for bullying. The percentage of teens affected by obesity has more than tripled since the 1970s. If obesity trends continue, most of today's children will have obesity by the age of 35. QUESTION Prevention of Obesity Answer: provide targeted nutritional advice—low carbohydrate diets with high protein eliminate sweetened liquid calories including juice recommend 60 minutes of activity on most days of the week for adults and children encourage good nutrition and activity at the family level, not just the individual level encourage 24-hour diet recall and use motivational interviewing techniques promote good sleep hygiene screen for obstructive sleep apnea—does the patient snore? awaken tired? awaken frequently at night? screen for depression in adolescents with irregular periods, screen for PCOS