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Exam (elaborations)

CSOWM CURRENT EXAM

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CSOWM CURRENT EXAM ...

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  • August 15, 2024
  • 37
  • 2024/2025
  • Exam (elaborations)
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  • CSOWM
  • CSOWM
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CSOWM CURRENT MIDTERM EXAM 2024-2025


Management of BMI >/= 25 - Diet, Exercise, and Behavior

Management of BMI >/= 30 - ANSWER Diet, exercise, behaviour, and medication


Management of BMI >/= 27 + comorbidities - ANSWER Diet, exercise, behaviour,
and medication


Management of BMI >/=35 + cormorbidity: ANSWER Bariatric surgery


Management of BMI >/= 40 - ANSWER Bariatric surgery.


Co-morbidities: T2DM.

HTN

OSA and other respiratory diseases.

NAFLD

OA

Lipid abnormalities

gastrointestinal disorders

Heart illness.


Medication assessment - ANSWER: Every month for three months, then every
three months.

,Effective weight loss rate - ANSWER >/=5% in three months


Avoid these weight-loss medications with HTN/HD - ANSWER Sympathomimetic
(phentermine/diethylpropion)


Avoid these weight loss drugs with CVD: ANSWER Sympathomimetic


T2DM treatment plus weight loss medications: ANSWER GLP-1 analogue
(reduces insulin-related weight gain) or SGLT-2 inhibitors plus metformin. If using
insulin, I prefer basal instead of combo.


Drugs that cause weight gain - ANSWER Tricyclic antidepressants (amitriptyline)

oral contraceptives (Ortho Tri-Cyclen and Yaz)

antipsychotics (risperidone)

anticonvulsants

Glucocorticoids (cortisol).

sulfonylureas (Glimepiride and Glipizide)

Glitazones (Actos)

B-blockers (propranolol, metoprolol, and atenolol)


Hormonal signals for appetite - Answer: CCK-duodenum.

K cells in the duodenum and jejunum: Gatric inhibitory polypeptide.

PYY: ileum and colon.

GLP-1 in the ileum

,Pancreas - Insulin


Adipose tissue: leptin.


Liver- glucagon


GLP-1 is secreted in reaction to glucose, which increases insulin release from the
pancreas and satiety.


Ghrelin is produced in the stomach and is orexigenic.


Leptin is proportional to fat mass and has anorexigenic properties.


Inhibits appetite


PYY - ANSWER Ileum and colon are anorexigenic


CCK - Answer: duodenum, anorexigenic.


Insulin - Answer Pancreas, anorexigenic.


Phentermine: noradrenergic, dopaminergic sympathomimetic amine.


Start with 7.5-15mg/d, and only raise if there are no results.


Do not prescribe for someone with a history of psychiatric disorders or substance
misuse.

, ANSWER: Lorcaserin (Belviq) activates the serotonin type 2 receptor.


Brand name: Phentermine/Topiramate - Answer Qysemia.

Answer for Phentermine/Topiramate (Qysemia): Phentermine is a stimulant.


Topiramate: neurostabilizer + antiseizure


Bupropion (Wellbutrin) - ANSWER Dopamine and norepinephrine reuptake
inhibitor


stimulates POMC neurons.


Sibutramine (Meridia) - Discontinued-


Norepinephrine, Serotonin, and Dopamine Reuptake Inhibitor Anorectic



Approved for usage by teenagers over the age of 16



ANSWER: Orlistat limits the absorption of 25-30% of fat calories.



SLGT-2 inhibitors (optimal for T2DM patients)--ex. Invokana - ANSWER
promotes weight loss by blocking the reabsorption of carbohydrates and water.



Band name: Victoza/Sandexa, ANSWER Liraglutide

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