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CSOWM EXAM WITH ALL QUESTIONS AND VERIFIED
ANSWERS


Peptide YY - ANSWER A peptide hormone generated in the intestines (ilium and
colon) that slows gastric and pancreatic secretions and lowers appetite.

Cholecystokinin is a hormone released by cells in the duodenum that stimulates the
flow of bile into the intestine as well as the secretion of pancreatic enzymes; it
suppresses hunger.


stomach inhibitory polypeptide - ANSWER Hormone generated by the intestine;
inhibits stomach secretion and motility while increasing insulin release from beta
cells in ANSWER to elevated blood glucose levels. triggered by the presence of fat
and glucose in the small intestine and increases satiety.


Glucagon-like peptide 1 (GLP-1) - ANSWER substance secreted by the intestines
(ileum) in ANSWER to glucose, FA, and fibre and goes to the brain--stops eating;
suppresses gastric secretion and glucagon secretion and increases insulin secretion


Ghrelin - ANSWER hormone released by an empty stomach; sends "I'm hungry"
messages to the brain; rises with time since last feeding


Leptin - A protein hormone generated by fat cells; when abundant, causes the brain
to enhance metabolism and decrease hunger; high in overweight/obese people
(leptin resistant).


hormonal ANSWER to weight loss - ANSWER elevated ghrelin and decreased
PYY, CCK, leptin, insulin; may last for more than a year and lead to increased
calorie intake and weight regain.


phentermine/topiramate (qsymia) dosage - ANSWER 3.75/23mg per day for 2
weeks, then increase to 7.5/46mg per day; max dose 15/92mg only if pts have not
lost >5% BW in 12 weeks (taper progressively DT higher risk seizure)

,Phentermine/topiramate mechanism: ANSWER increases norepinephrine in the
hypothalamus, causing to appetite control.


Side effects of phentermine with topiramate include sleeplessness, dry mouth,
constipation, paraesthesia, dizziness, and dysgeusia.


Contraindications for phentermine/topiramate include hyperthyroidism, glaucoma,
MAO inhibitors, and sympathomimetic amines.


Orlistat (Xenical) dosage: prescription 120mg tid; OTC 60mg tid during or within 1
hour of a fat-containing meal.


orlistat mechanism of action: ANSWER inhibits gastric and pancreatic lipase.


Orlistat side effects include steatorrhea, faecal incontinence, and impaired
absorption of fat-soluble vitamins.


Orlistat contraindications include pregnancy, chronic malabsorption syndrome, and
cholestasis.


Lorcaserin (Belviq) dose - ANSWER 10 mg bid; DC if <5% weight loss within 12
weeks.


Lorcaserin mechanism of action: ANSWER 5HT2C receptor agonist (binding site
for serotonin; mood, eating, reproduction, anxiety); promotes satiety.


lorcaserin side effects include dry mouth, fatigue, constipation, and hypoglycemia.

,Lorcaserin contraindications - ANSWER patients taking SSRI or SNRI (increased
risk of serotonin syndrome), pregnancy, and breastfeeding


Naltrexone/Bupropion (Contrave) dosage - ANSWER 8/90mg (increase 1 tablet per
week until max dose 4/d=32/360mg); DC usage if <5% BW decreased in 12 weeks.


Bupropion, a dopamine and norepinephrine reuptake inhibitor, and naltrexone, an
opioid antagonist, work together to reduce appetite and cravings.


Side effects of naltrexone/bupropion include constipation, headache, and dizziness.


Contraindications for naltrexone/bupropion include uncontrolled hypertension,
seizure disorders, AN/BN, and drug/alcohol addictions or withdrawal.


Liraglutide (Saxenda) dose - ANSWER 3 mg injectable (1.8mg for Diabetes)


Liraglutide's mode of action is an analogue of human GLP-1 that activates GLP-1
receptors directly. Slows stomach emptying, increases glucose-dependent insulin
release, and suppresses glucagon release.



Liraglutide side effects - ANSWER N/V: pancreatitis and elevated heart rate


Liraglutide Contraindications: ANSWER Hx of medullary thyroid carcinoma.


Diabetes medications that cause weight gain include insulin, sulfonylureas (amaryl,
glucotrol, glyburide), glitinides (glipizide, glimepiride), and thiazolidinediones
(actos, avandia).


Diabetes medications that promote weight loss: metformin, pramlintide.

, Weight-neutral diabetic medications: dipeptidyl peptidase 4 inhibitor (....liptin),
alpha-glucosidase inhibitor (acarbose, miglitol).



Antidepressant medicines that cause weight gain - ANSWER paroxetine (SSRI),
amitriptyline (tricyclic), mirtazapine (noradrenergic)



Underweight BMI: <18.5



Normal BMI range: 18.5-24.9.



Overweight BMI range: 25-29.9



High waist circumference for men or women - ANSWER >40 inches (>102 cm) in
men

More than 35 inches (88 cm) in ladies



Class 1 Obesity BMI: 30-34.9



Class 2 Obesity BMI: 35-39.9



Class 3 Obesity BMI - Answer 40 or above

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