Review Questions to practice for
CSOWM
A 12-‐year-‐vintage lady provided as a brand new patient for nicely toddler care with BMI for
age and gender on the 98th percentile. At the first visit, the patient turned into counseled
approximately appropriate weight reduction techniques and regarded encouraged to make
changes to diet and bodily pastime. Four weeks later, the affected person has misplaced 12 lb
(5.Four kg), which she attributes to dietary changes, and states that her pastime level become
now not elevated. Which of the subsequent is the maximum appropriate subsequent step in
management?
1. Develop a physical interest software
2. Evaluate for immoderate caloric limit
3. Discuss her unwillingness to start workout
four. Schedule a observe-‐up visit in another four weeks - ANS-Answer: 2. Evaluate for
immoderate caloric restrict
A 28 yr old lady, BMI 30 kg/m2, has been following the economic Weight Watchers program
on-line for the past 4 months. Based on her modern and favored purpose weight, she changed
into assigned 30 factors in step with day which she has faithfully accompanied. Since end result
and vegetables are not assigned points, she has been ingesting 6 extra servings of fruit in line
with day. She gives frustrated on the grounds that she has most effective misplaced three lbs.
On average, how many extra energy is she consuming day by day from fruit that she isn't
counting toward her nutritional consumption?
1. 120 kcal
2. 240 kcal
three. 360 kcal
four. 480 kcal - ANS-Answer: 3. 360 kcal
A 32 12 months vintage patient with a BMI of 38 kg/m2 is placed on a low calorie food plan and
correctly loses 12% of her frame weight over 5 months. However, she is experiencing an growth
in starvation that is making it difficult for her to hold to stick to the dietary routine. What are the
underlying organic mechanisms that specify her increased hunger?
1. Accelerated GLP-‐1 and ghrelin tiers leading to extended POMC launch within the
hypothalamus
2. Decreased GLP-‐1 and leptin tiers main to decreased POMC launch inside the hypothalamus
3. Decreased PYY and ghrelin degrees main to increased NPY release in the hypothalamus
four. Accelerated ghrelin and leptin levels leading to improved NPY release inside the
hypothalamus - ANS-Answer: 2. Decreased GLP-‐1 and leptin levels main to decreased POMC
launch within the hypothalamus
,A 32-‐12 months-‐old woman is thinking about a weight loss plan but is particularly ambivalent.
She recognizes that her weight is causing negative clinical effects. According to Prochaska's
Stages of Change model, what is her cutting-edge level of exchange?
1. Action
2. Preparation
3. Contemplation
4. Precontemplation - ANS-Answer: three. Contemplation
A 38-‐yr-‐vintage man with type 2 diabetes, glycosylated hemoglobin (HbA1c) of seven.Eight%,
is positioned on metformin XR 500 mg consistent with day via his number one care medical
doctor. The patient referred to an initial weight loss of six kilos (2.72 kg) but evolved frequent
diarrhea. His medicinal drug became switched to glyburide 10 mg in line with day, and he
received 18 pounds (eight.Sixteen kg) in months. The patient presents to the obesity medicinal
drug medical doctor's workplace involved approximately the weight gain. Repeat HbA1c is
7.4%. After discontinuing glyburide, which of the subsequent medications might be maximum
useful to add to this affected person's regimen?
1. Insulin
2. Liraglutide
3. Pioglitazone
four. Phentermine - ANS-Answer: 2. Liraglutide
A 39-‐year-‐old guy in suitable health who engages in a median quantity of physical hobby
consumes 2,two hundred kcalories/day. Approximately how a lot of this guy's day by day
kcalories are expended in put up-‐prandial thermogenesis?
1. 110
2. 220
three. 330
4. 440 - ANS-Answer: 2. 220
A 39-year-vintage male with type 2 diabetes for the past three years affords for a follow-up go
to. His body mass index is forty three kg/m2 and he has these days joined a gymnasium and is
running with a registered dietitian. His HbA1c is eight.3% and he is inquisitive about remedy
options so one can help him with weight loss as well as glycemic manipulate. Which of the
following incretin-primarily based treatment plans has proven the finest glucose-decreasing
efficacy, with finest capability for weight loss?
A. Semaglutide once weekly
b. Liraglutide as soon as every day
c. Tirzepatide as soon as weekly
d. Exenatide once weekly - ANS-Answer: C. Tirzepatide as soon as weekly
Explanation: In a head-to-head study evaluating semaglutide 1.0 mg weekly with tirzepatide
five, 10, or 15 mg weekly, advanced HbA1c reduction became established with all 3 doses of
tirzepatide (-2.30% vs 1.86% for tirzepatide 15 mg vs semaglutide 1 mg, estimated remedy
difference of -0.45% [95% CI, -0.57 to -0.32; P<0.001]). In addition, proof from the trial indicates
that patients treated with tirzepatide five, 10, or 15 mg weekly showed a more change from
baseline in body weight vs semaglutide 1 mg. Although head-to-head research some of the
highest doses of once weekly semaglutide (2.Zero mg), dulaglutide (4.Five mg), and tirzepatide
, (15 mg weekly) aren't available, those GLP-1 receptor agonists and the twin agonist of GLP-1
and GIP are considered to have the best efficacy and display extra HbA1c discounts than other
GLP-1 receptor agonists, consisting of exenatide once weekly and liraglutide.
Frías JP, Davies MJ, Rosenstock J et al. Tirzepatide versus semaglutide once weekly in
sufferers with kind 2 diabetes. N Engl J Med. 2021;385(6):503-15.
ElSayed NA, Aleppo G, Aroda VR et al. Nine. Pharmacologic strategies to glycemic remedy:
standards of care in diabetes—2023. Diabetes Care. 2023;forty six(Suppl 1):S140-fifty seven.
A forty 12 months antique girl is establishing care after recently transferring from a unique
kingdom. She underwent a Roux-‐en-‐Y gastric pass manner one year ago without
complications and currently feels properly. Which of the following biochemical exams need to be
ordered at the moment?
1. Niacin, vitamin B12, and zinc
2. Calcium, magnesium, and nutrition A
three. 25-‐hydroxy-‐vitamin D, intact PTH, and nutrition B12
four. Intact PTH, 1,25-‐dihydroxy-‐diet D, and thiamin - ANS-Answer: 3. 25-‐hydroxy-‐vitamin
D, intact PTH, and nutrition B12
A forty-‐year-‐vintage guy with a BMI of 32 kg/m2, history of kind 2 diabetes, kidney stones,
migraines, and depression is concerned approximately his weight. Which of the following
medicinal drugs ought to be used with warning because of an elevated risk for nephrolithiasis?
1. Liraglutide (Saxenda™)
2. Bupropion/naltrexone (Contrave™)
three. Lorcaserin (Belviq™)
4. Phentermine/topiramate ER (Qsymia™) - ANS-Answer: 4. Phentermine/topiramate ER
(Qsymia™)
A 42 year old girl offers on your weight loss clinic after struggling to shed pounds for the closing
five years. She is sixty seven.7 inches (172 cm) in height and weighs 176 lb. (eighty kg) (BMI 27
kg/m2). She participates in spin training 3 days in keeping with week. She is inquisitive about
starting a low glycemic index weight loss program for weight reduction. What advice are you
able to proportion with her approximately a low glycemic index diet?
1. Fresh squeezed juice and entire fruits have the same glycemic index
2. Glycemic index takes into consideration the ripeness of the food
3. A low glycemic index meals manner it has top nutritional value
4. Glycemic index takes into account whether or not protein or fats are consumed with the
carbohydrates - ANS-Answer: 2. Glycemic index takes into consideration the ripeness of the
food
A 45-‐yr-‐vintage Japanese-‐American guy affords as a brand new patient. He has a BMI 23
kg/m2, waist circumference 36 inches (92 cm), normal blood stress, and normal physical
examination. Compared to Caucasians, how should the patient's risk for type 2 diabetes be
categorised?
1. Increased
2. Decreased
3. Unchanged
