FCM Jeopardy (4/19)

1

100

According to the National Institute of Health, and BMI of 37.8 would be in this class of obesity

What is Class II?

Class I: BMI 30-34.9
Class II: BMI 35- 39.9
Class III: BMI > 40

200

According to the National Institute of Health, and a person with a BMI of 28.5 would be in interpreted as this

What is overweight?

< 18.5 - Underweight
18.5 - 24.9 Normal weight
25-29.9 Overweight
> 30 Obese 

300

patients need to have approximately this amount of a caloric deficit to loos 1 pound of weight/week.

what is 3500?

400

*non jeopardy style question* what are some of the actions of HMG-CoA reductase inhibitors? 

• Stabilize existing plaques, reduce inflammation, and decrease the risk of plaque rupture and myocardial infarction
• Decrease CHD and all-cause mortality
• Decrease LDL by 18% to 55%
• Increase HDL by 5% to 15%
• Decrease triglycerides by 7% to 30%

500

thiazide diuretics, beta-blockers, oral estrogens, and protease inhibitors can cause this. 

What are dyslipidemias?

2

100

*non jeopardy style question* what are some reasonable short and long term goals for weight loss? 

Reasonable long-term goal: A modest 5% to 10% reduction in body weight can produce significant benefits in health outcomes.

Reasonable short-term goal: Losing half a pound to a pound a week.

200

This condition, characterized by fatigue, cold intolerance, and constipation, may predispose patients to secondary obesity

What is hypothyroidism?

300

This condition, characterized by easy bruising, hyperpigmentation, and muscle weakness, may predispose patients to secondary obesity

What is Cushing's syndrome?

400

This condition, characterized by decreased libido, may predispose patients to secondary obesity

What is hypogonadism?

500

*non jeopardy style question* high intensity therapy is recommenced for:

• Patients ≤ 75 years of age with clinical ASCVD and no safety concerns
• Patients with LDL cholesterol > 190 mg/dL
• People with diabetes who are 40–75 years of age with multiple ASCVD risk factors

3

100

This condition, characterized by snoring, daytime somnolence, and morning headaches, is associated with obesity

What is sleep apnea?

200

This condition, which may cause polydipsia and polyuria, is associated with obesity 

What is diabetes?

300

This condition (think broadly) is associated with chest pain or pressure, dyspnea, or changes in exercise tolerance 

What is CVD?

400

this condition is characterized by 3 of the 5:

• Fasting plasma glucose ≥ 100 mg/dL (or on medical therapy for hyperglycemia)
• BP ≥ 130/85 mmHg (or on medical therapy for hypertension)
• Triglycerides ≥ 150 mg/dL, non-fasting (or on medical therapy for hypertriglyceridemia)
• High density lipoprotein (HDL) cholesterol < 40 mg/dL for men, < 50 mg/dL for women (or on medical therapy for low HDL cholesterol)
• Abdominal obesity (waist circumference > 40" for men, > 35" for women)

What is Metabolic syndrome?

500

*non jeopardy style question* what are two common side effects of statin therapy

Hepatic dysfunction

Myopathy

**Hepatic function tests (ALT, AST, alkaline phosphatase, total bilirubin) should be measured in patients who develop symptoms of hepatotoxicity while on statin therapy. CK should be measured before starting statin therapy in patients who are at increased risk for myopathy, and in any patient who develops symptoms of myopathy or objective muscle weakness during statin treatment.

4

100

hypertension, carotid bruits, diminished peripheral pulses, increased abdominal aortic size are all concerning for what category of disease (think broadly)

what is vascular disease?

200

increase insulin resistance, LDL cholesterol, VLDL and triglycerides, and a decrease in HDL cholesterol 

what are the metabolic effects of obesity?

300

*non jeopardy style questions* what are three surgical procedures that are offered to patients?

Gastric bypass (Roux-en-Y): partitioning of the stomach with attachment of the proximal stomach to the jejunum with resultant malabsorptive and volume-restrictive effects

Sleeve gastrectomy: partial gastrectomy in which a tubular stomach is created with volume-restrictive effects

Biliopancreatic diversion with duodenal switch: anastomotic surgery with resultant malabsorptive and volume-restrictve effects

400

this GLP-1 agonist is used for management of obesity and is contraindicated in pregnancy and not recommended in severe renal or hepatic impairment.

what is Liraglutide?

500

this diet is rich in Vegetables, Fresh fruits, Whole grains, Lean meats: poultry, pork, fish, and tree nuts

what is the Mediterranean diet?

Bonus q -- what is the specific utility for this diet?

5

100

A better way to describe this physical exam finding commonly described as a "buffalo hump"

What is a dorsocervical fat pad?

200

Aggressive lifestyle modification (dietary modification, physical activity, weight loss, and smoking cessation) is first-line therapy for this condition.

What is metabolic syndrome?

300

*none jeopardy style* what are the 5 A's of behavioral counseling?

1. Assess the patient's dietary practices and related risk factors.
2. Advise the patient to change dietary practices.
3. Agree with the patient on goals.
4. Assist the patient in changing dietary practices or addressing motivational barriers.
5. Arrange follow-up, support, and/or referral for the patient.

400

*none jeopardy style question* who should be a part of a patient's care team regarding concern for unhealthy weight?

A nutritionist, dietitian, and/or health educator

500

As patients lose weight, their caloric requirements decrease and they eventually reach a point where they stop losing weight, even if they maintain the caloric intake previously producing weight loss.

What is the plateau phenomenon?