GNRS 5669 UTMB FNP I Exam 4 Questions With Complete
Solutions
Obesity: Surgery
Reserved for BMI > 40 or > 35 if they have
complications of the obesity.
Has failed more conventional weight loss methods.
Vertical-banded (Mason) gastroplasty.
Roux-en-Y gastric bypass (50% loss of initial body
weight).
Complications following sx:
Peritonitis, abdominal wall hernia, dumping
syndrome, infxn, acute cholecystitis,
hypoglycemia, pyloric outlet obstruction, chronic
diarrhea and N/V.
,Obesity: Pharmacologic Tx
NIH guidelines suggest aggressive pharmacologic
tx if BMI is 30 > W/O concomitant risk factors
BMI of 27 or greater w/ 2 major risk factors. ADRs,
lack of evidence for LT effectiveness and potential
for drug dependence.
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Appetite suppressants (Catecholaminergic)
Amphetamines
Nonamphetamine schedule IV
Phentermine
Phenylpropanolamine OTC
Diethylpropion (Tenuate)
------------------------------------------------------------------
Sibutramine HCl monohydrate (NNRI) 10 mg
PO/daily
SE: (↑) BP and HR, constipation, insomnia and HA.
,CI: CV events
------------------------------------------------------------------
Orlistat (block fat absorption in GI tract)
120 mg TID w/meals
SE: Diarrhea, gas, abdominal cramping and oily
rectal leakage. Some studies suggest may also
inhibit absorption of fat soluble vitamins.
Patterns of thyroid function
Euthyroid
Hyperthyroid
Hypothyroid
, Thyroiditis: Various forms
Thyroid inflammation.
Acute
1. Bacterial or fungal infxn.
2. Radiation type after tx and Amiodarone.
-----------------------------------------------------------------
Subacute: Most common and in women age 40-50
following an acute viral infxn. Associated w/HLA-
Bw35.
1. Silent (mod. enlarged and nontender).
2. Mycobacterial infxn.
Solutions
Obesity: Surgery
Reserved for BMI > 40 or > 35 if they have
complications of the obesity.
Has failed more conventional weight loss methods.
Vertical-banded (Mason) gastroplasty.
Roux-en-Y gastric bypass (50% loss of initial body
weight).
Complications following sx:
Peritonitis, abdominal wall hernia, dumping
syndrome, infxn, acute cholecystitis,
hypoglycemia, pyloric outlet obstruction, chronic
diarrhea and N/V.
,Obesity: Pharmacologic Tx
NIH guidelines suggest aggressive pharmacologic
tx if BMI is 30 > W/O concomitant risk factors
BMI of 27 or greater w/ 2 major risk factors. ADRs,
lack of evidence for LT effectiveness and potential
for drug dependence.
------------------------------------------------------------------
Appetite suppressants (Catecholaminergic)
Amphetamines
Nonamphetamine schedule IV
Phentermine
Phenylpropanolamine OTC
Diethylpropion (Tenuate)
------------------------------------------------------------------
Sibutramine HCl monohydrate (NNRI) 10 mg
PO/daily
SE: (↑) BP and HR, constipation, insomnia and HA.
,CI: CV events
------------------------------------------------------------------
Orlistat (block fat absorption in GI tract)
120 mg TID w/meals
SE: Diarrhea, gas, abdominal cramping and oily
rectal leakage. Some studies suggest may also
inhibit absorption of fat soluble vitamins.
Patterns of thyroid function
Euthyroid
Hyperthyroid
Hypothyroid
, Thyroiditis: Various forms
Thyroid inflammation.
Acute
1. Bacterial or fungal infxn.
2. Radiation type after tx and Amiodarone.
-----------------------------------------------------------------
Subacute: Most common and in women age 40-50
following an acute viral infxn. Associated w/HLA-
Bw35.
1. Silent (mod. enlarged and nontender).
2. Mycobacterial infxn.
