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Old 08-19-2012
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Default patient is obese...what tests to order? and WHY ?

A 41-year-old asymptomatic man is evaluated during a routine
physical examination. His only medical problem is obesity for
which he has never sought treatment. Medical history is
otherwise unremarkable, and he takes no medications.
On physical examination, temperature is normal, blood pressure is 127/79 mm Hg, pulse rate is 80/min, and respiration rate is
14/min. BMI is 39. Waist circumference is 112.2 cm (44 in). The
remainder of the physical examination is normal.
The patient is counseled regarding his obesity.
Which of the following is the most appropriate initial
evaluation for this patient?
(A) Complete blood count and serum electrolytes
(B) Electrocardiogram and chest x-ray
(C) Fasting glucose, lipid profile, and serum creatinine
(D) Sleep study and pulse oximetry
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Old 08-19-2012
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(C) Fasting glucose, lipid profile, and serum creatinine for Metabolic syndrome.
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Quote:
Originally Posted by Novobiocin View Post
(C) Fasting glucose, lipid profile, and serum creatinine for Metabolic syndrome.



yes am agree with u
c) fasting glucose,lipid profile and serum creatinine levels

Clinicaly at midle age we also recommend ECG but not CXR
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Quote:
Originally Posted by riya_rai84 View Post
yes am agree with u
c) fasting glucose,lipid profile and serum creatinine levels

Clinicaly at midle age we also recommend ECG but not CXR
C Sure, and as far as ECG is concerned with the abd obesity and metabolic syndromes as our concern We'd prefer the glucose levels over ECG, right?
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Quote:
Originally Posted by Novobiocin View Post
(C) Fasting glucose, lipid profile, and serum creatinine for Metabolic syndrome.
ya thats correct . any simple reason why we testing cr? its not in criteria to dx metabolic syndrome ?
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Quote:
Originally Posted by tyagee View Post
ya thats correct . any simple reason why we testing cr? its not in criteria to dx metabolic syndrome ?
It's one of the WHO criteria
Quote:
The World Health Organization criteria (1999) require the presence of any one of diabetes mellitus, impaired glucose tolerance, impaired fasting glucose or insulin resistance, AND two of the following:
  • Blood pressure: ≥ 140/90 mmHg
  • Dyslipidemia: triglycerides (TG): ≥ 1.695 mmol/L and high-density lipoprotein cholesterol (HDL-C) ≤ 0.9 mmol/L (male), ≤ 1.0 mmol/L (female)
  • Central obesity: waist:hip ratio > 0.90 (male); > 0.85 (female), or body mass index > 30 kg/m2
  • Microalbuminuria: urinary albumin excretion ratio ≥ 20 g/min or albumin:creatinine ratio ≥ 30 mg/g
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