CSOWM CURRENT MIDTERM EXAM 2024-2025
Management of BMI >/= 25 - Diet, Exercise, and Behavior
Management of BMI >/= 30 - ANSWER Diet, exercise, behaviour, and medication
Management of BMI >/= 27 + comorbidities - ANSWER Diet, exercise, behaviour,
and medication
Management of BMI >/=35 + cormorbidity: ANSWER Bariatric surgery
Management of BMI >/= 40 - ANSWER Bariatric surgery.
Co-morbidities: T2DM.
HTN
OSA and other respiratory diseases.
NAFLD
OA
Lipid abnormalities
gastrointestinal disorders
Heart illness.
Medication assessment - ANSWER: Every month for three months, then every
three months.
,Effective weight loss rate - ANSWER >/=5% in three months
Avoid these weight-loss medications with HTN/HD - ANSWER Sympathomimetic
(phentermine/diethylpropion)
Avoid these weight loss drugs with CVD: ANSWER Sympathomimetic
T2DM treatment plus weight loss medications: ANSWER GLP-1 analogue
(reduces insulin-related weight gain) or SGLT-2 inhibitors plus metformin. If using
insulin, I prefer basal instead of combo.
Drugs that cause weight gain - ANSWER Tricyclic antidepressants (amitriptyline)
oral contraceptives (Ortho Tri-Cyclen and Yaz)
antipsychotics (risperidone)
anticonvulsants
Glucocorticoids (cortisol).
sulfonylureas (Glimepiride and Glipizide)
Glitazones (Actos)
B-blockers (propranolol, metoprolol, and atenolol)
Hormonal signals for appetite - Answer: CCK-duodenum.
K cells in the duodenum and jejunum: Gatric inhibitory polypeptide.
PYY: ileum and colon.
GLP-1 in the ileum
,Pancreas - Insulin
Adipose tissue: leptin.
Liver- glucagon
GLP-1 is secreted in reaction to glucose, which increases insulin release from the
pancreas and satiety.
Ghrelin is produced in the stomach and is orexigenic.
Leptin is proportional to fat mass and has anorexigenic properties.
Inhibits appetite
PYY - ANSWER Ileum and colon are anorexigenic
CCK - Answer: duodenum, anorexigenic.
Insulin - Answer Pancreas, anorexigenic.
Phentermine: noradrenergic, dopaminergic sympathomimetic amine.
Start with 7.5-15mg/d, and only raise if there are no results.
Do not prescribe for someone with a history of psychiatric disorders or substance
misuse.
, ANSWER: Lorcaserin (Belviq) activates the serotonin type 2 receptor.
Brand name: Phentermine/Topiramate - Answer Qysemia.
Answer for Phentermine/Topiramate (Qysemia): Phentermine is a stimulant.
Topiramate: neurostabilizer + antiseizure
Bupropion (Wellbutrin) - ANSWER Dopamine and norepinephrine reuptake
inhibitor
stimulates POMC neurons.
Sibutramine (Meridia) - Discontinued-
Norepinephrine, Serotonin, and Dopamine Reuptake Inhibitor Anorectic
Approved for usage by teenagers over the age of 16
ANSWER: Orlistat limits the absorption of 25-30% of fat calories.
SLGT-2 inhibitors (optimal for T2DM patients)--ex. Invokana - ANSWER
promotes weight loss by blocking the reabsorption of carbohydrates and water.
Band name: Victoza/Sandexa, ANSWER Liraglutide
Management of BMI >/= 25 - Diet, Exercise, and Behavior
Management of BMI >/= 30 - ANSWER Diet, exercise, behaviour, and medication
Management of BMI >/= 27 + comorbidities - ANSWER Diet, exercise, behaviour,
and medication
Management of BMI >/=35 + cormorbidity: ANSWER Bariatric surgery
Management of BMI >/= 40 - ANSWER Bariatric surgery.
Co-morbidities: T2DM.
HTN
OSA and other respiratory diseases.
NAFLD
OA
Lipid abnormalities
gastrointestinal disorders
Heart illness.
Medication assessment - ANSWER: Every month for three months, then every
three months.
,Effective weight loss rate - ANSWER >/=5% in three months
Avoid these weight-loss medications with HTN/HD - ANSWER Sympathomimetic
(phentermine/diethylpropion)
Avoid these weight loss drugs with CVD: ANSWER Sympathomimetic
T2DM treatment plus weight loss medications: ANSWER GLP-1 analogue
(reduces insulin-related weight gain) or SGLT-2 inhibitors plus metformin. If using
insulin, I prefer basal instead of combo.
Drugs that cause weight gain - ANSWER Tricyclic antidepressants (amitriptyline)
oral contraceptives (Ortho Tri-Cyclen and Yaz)
antipsychotics (risperidone)
anticonvulsants
Glucocorticoids (cortisol).
sulfonylureas (Glimepiride and Glipizide)
Glitazones (Actos)
B-blockers (propranolol, metoprolol, and atenolol)
Hormonal signals for appetite - Answer: CCK-duodenum.
K cells in the duodenum and jejunum: Gatric inhibitory polypeptide.
PYY: ileum and colon.
GLP-1 in the ileum
,Pancreas - Insulin
Adipose tissue: leptin.
Liver- glucagon
GLP-1 is secreted in reaction to glucose, which increases insulin release from the
pancreas and satiety.
Ghrelin is produced in the stomach and is orexigenic.
Leptin is proportional to fat mass and has anorexigenic properties.
Inhibits appetite
PYY - ANSWER Ileum and colon are anorexigenic
CCK - Answer: duodenum, anorexigenic.
Insulin - Answer Pancreas, anorexigenic.
Phentermine: noradrenergic, dopaminergic sympathomimetic amine.
Start with 7.5-15mg/d, and only raise if there are no results.
Do not prescribe for someone with a history of psychiatric disorders or substance
misuse.
, ANSWER: Lorcaserin (Belviq) activates the serotonin type 2 receptor.
Brand name: Phentermine/Topiramate - Answer Qysemia.
Answer for Phentermine/Topiramate (Qysemia): Phentermine is a stimulant.
Topiramate: neurostabilizer + antiseizure
Bupropion (Wellbutrin) - ANSWER Dopamine and norepinephrine reuptake
inhibitor
stimulates POMC neurons.
Sibutramine (Meridia) - Discontinued-
Norepinephrine, Serotonin, and Dopamine Reuptake Inhibitor Anorectic
Approved for usage by teenagers over the age of 16
ANSWER: Orlistat limits the absorption of 25-30% of fat calories.
SLGT-2 inhibitors (optimal for T2DM patients)--ex. Invokana - ANSWER
promotes weight loss by blocking the reabsorption of carbohydrates and water.
Band name: Victoza/Sandexa, ANSWER Liraglutide
