Final Exam: NR 577 (NR577) Primary Care Management of Adolescents and Adults Final Exam Review| Guide with Verified Answers| Latest 2023/
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QUESTION
Onychomycosis
Answer:
nails are only area involved
QUESTION
Eczema
Answer:
itchy ozzy crusted lesion. The itch before the rash
QUESTION
Lichen planus
Answer:
thick non-scaly lesions limited to wrists limbs and oral mucosa
QUESTION
Risks of obesity
Answer:
HTN, Dyslipidemia, DM2, Coronary heart disease, stroke, gallbaldder disease, OA, sleep apnea, Cancer, PCOS, mental health, eating dis- orders, generalized pain
QUESTION
BMI
Answer:
Underweight < 18.5
Normal 18.5-24.9
Overweight: 25-29.9
Obese: 30 - 24.9
Extremely Obese: 35 >
QUESTION
Physical exam for obesity
Answer:
possible secondary causes (thyroid disease, adren- al disorder, etc.)
possible complications of obesity (DM, CVD, PVD, etc.) BMI
waist/hip circumference—measurement of visceral fat neck circumference—due to risk of OSA
obesity associate skin disorders—candida rashes, hirsutism, acanthosis nigricans, skin tags, striae, and pressure ulcers
respiratory—decreased breath sounds secondary to obesity hypoventilation cardiac—murmur associated with heart failure
abdominal—RUQ pain, Murphy's sign (higher incidence in gallbladder issues and fatty liver)
musculoskeletal—OA
psychological—depression (use Patient Health Questionnaire PHQ-9 screening tool)
QUESTION
Dx testing for obesity
Answer:
TSH, HbA1C, lipid panel, LFT, BUN, Uric Acid, Vt D, CBC, Urine microalbumin, EKG Becasue:All the tests listed should be performed to rule out secondary causes of obesity. Risk factors associated with obesity should be assessed, especially those associated with coronary artery disease such as hyperlipidemia, insulin resistance, type 2 diabetes.
QUESTION
Differential dx for obesity
Answer:
hypothyroidism
Cushing's syndrome hypothalamic injury
mesomorphism (bodybuilders, wrestlers)
genetic diseases: Prader Willi or Pickwickian syndrome.
QUESTION
Tx obesity
Answer:
Diet, physical activity, behavior modification, Pharmacological man- agement
QUESTION
Orlistat
Answer:
blocks absorption of fat in GI tract
QUESTION
Lorcaserin
Answer:
selective serotonin 5-HT2C agonists reduces appetite
QUESTION
Phentermine
Answer:
suppresses appetite, stimulant Rx
QUESTION
Naltrexone-bupropion
Answer:
unknown mechansim
QUESTION
Ozempic, Trulicity, wegovy
Answer:
GLP-1 medications
QUESTION
Surgical interventions for obesity
Answer:
lap band vertical sleeve gastrectomy
Roux-en-Y gastric bypass duodenal switch
QUESTION
Bariatric surgery
Answer:
should be reserved for those patients with a BMI over
40kg/m2 without comorbidities OR over 35kg/m2 with comorbid condition
QUESTION
Adolescent obesity
Answer:
increases the individual's risk for acute physical and psychological health concerns, including early signs of type II diabetes, asthma, sleep apnea, fatty liver, low self-esteem, and being at greater risk for bullying. The percentage of teens affected by obesity has more than tripled since the 1970s. If obesity trends continue, most of today's children will have obesity by the age of 35. [Show Less]