CSOWM COMPREHENSIVE TEST PAPER
QUESTIONS AND SOLUTIONS GRADED A+
●● Management of BMI >/=30
Answer: Diet, exercise, behavior + pharmacotherapy
●● Management of BMI >/= 27 + comorbidity
Answer: Diet, exercise, behavior + pharmacotherapy
●● Management of BMI >/=35 + cormorbidity
Answer: Bariatric surgery
●● Management of BMI >/=40
Answer: Bariatric surgery
●● Co-morbidities
Answer: T2DM
HTN
OSA and other respiratory disorders
NAFLD
OA
lipid abnormalities
,gastrointestinal disorders
heart disease
●● Medication assessment
Answer: Every month x3 months, then every 3 months
●● Effective weight loss %
Answer: >/=5% in 3 months
●● Avoid these wt loss meds with HTN/HD
Answer: Sympathomimetics (phentermine/diethylproprion)
●● Avoid these wt loss medications with CVD
Answer: Sypathomimetics
●● T2DM treatment + medications to support weight loss
Answer: GLP-1 analog (mitigates associated weight gain due to insulin)
or SGLT-2 inhibitors + metformin. If using insulin, recommend basal
instead of combo
●● Drugs that induce weight gain
Answer: Tricyclic antidepressants (Amitriptyline)
oral contraceptives (Ortho Tri-Cyclen, Yaz)
,antipsychotics (Risperidone)
anticonvulsants
glucocorticoids (cortisol)
sulfonyureas- ( Glimepiride, Glipizide)
glitazones (Actos)
B-blockers (Propranolol, Metoprolol, Atenolol)
●● Hormonal signals for appetite
Answer: CCK- duodenum
K cells- duodenum and jejunum: gatric inhibitory polypeptide
PYY- ileum and colon
GLP-1 -ileum
Pancreas- Insulin
Adipose tissue: Leptin
Liver- glucagon
●● GLP-1
Answer: Secreted in response to glucose and promotes insulin release
from pancreas and satiety
, ●● Ghrelin
Answer: produced in the stomach, orexigenic
●● Leptin
Answer: proportional to fat mass, anorexigenic
Inhibits appetite
●● PYY
Answer: Ileum and colon, anorexigenic
●● CCK
Answer: duodenum, anorexigenic
●● Insulin
Answer: Pancreas, anorexigenic
●● Phentermine
Answer: noradrenergic, dopaminergic sympathomimetic amine
Start with 7.5-15mg/d, increase only with no results
QUESTIONS AND SOLUTIONS GRADED A+
●● Management of BMI >/=30
Answer: Diet, exercise, behavior + pharmacotherapy
●● Management of BMI >/= 27 + comorbidity
Answer: Diet, exercise, behavior + pharmacotherapy
●● Management of BMI >/=35 + cormorbidity
Answer: Bariatric surgery
●● Management of BMI >/=40
Answer: Bariatric surgery
●● Co-morbidities
Answer: T2DM
HTN
OSA and other respiratory disorders
NAFLD
OA
lipid abnormalities
,gastrointestinal disorders
heart disease
●● Medication assessment
Answer: Every month x3 months, then every 3 months
●● Effective weight loss %
Answer: >/=5% in 3 months
●● Avoid these wt loss meds with HTN/HD
Answer: Sympathomimetics (phentermine/diethylproprion)
●● Avoid these wt loss medications with CVD
Answer: Sypathomimetics
●● T2DM treatment + medications to support weight loss
Answer: GLP-1 analog (mitigates associated weight gain due to insulin)
or SGLT-2 inhibitors + metformin. If using insulin, recommend basal
instead of combo
●● Drugs that induce weight gain
Answer: Tricyclic antidepressants (Amitriptyline)
oral contraceptives (Ortho Tri-Cyclen, Yaz)
,antipsychotics (Risperidone)
anticonvulsants
glucocorticoids (cortisol)
sulfonyureas- ( Glimepiride, Glipizide)
glitazones (Actos)
B-blockers (Propranolol, Metoprolol, Atenolol)
●● Hormonal signals for appetite
Answer: CCK- duodenum
K cells- duodenum and jejunum: gatric inhibitory polypeptide
PYY- ileum and colon
GLP-1 -ileum
Pancreas- Insulin
Adipose tissue: Leptin
Liver- glucagon
●● GLP-1
Answer: Secreted in response to glucose and promotes insulin release
from pancreas and satiety
, ●● Ghrelin
Answer: produced in the stomach, orexigenic
●● Leptin
Answer: proportional to fat mass, anorexigenic
Inhibits appetite
●● PYY
Answer: Ileum and colon, anorexigenic
●● CCK
Answer: duodenum, anorexigenic
●● Insulin
Answer: Pancreas, anorexigenic
●● Phentermine
Answer: noradrenergic, dopaminergic sympathomimetic amine
Start with 7.5-15mg/d, increase only with no results