New Release: 2025 Edition

 Knowledge checks will be available every four weeks and consist of a checklist of objectives and questions based on the prior blog posts. In addition, brief explanations of the sample questions will also be included. As always, additional question banks should be incorporated into studying to enhance correlating and applying this knowledge foundation. Reference the prior blogs as needed. 

• What role do socioeconomic status and antibiotics have in regard to obesity risk factors? What about parenting style?
• What term refers to the environmental conditions in which the patient lives, plays, is educated, worships, etc.?
• Know the terms ACEs, COT, and IHBLT.
• What is the difference between motivational interviewing techniques in pre-adolescence compared to adolescents and adults?
• Know what FDA-approved pharmacologic therapies are available to those 12 years of age. What about recommendations for metabolic and bariatric surgery?
• Review and be familiar with all of the key action statements in the 2023 AAP guidelines (see the table at the bottom of the blog).

Sample Question Explanation: Intensive health behavior and lifestyle treatment (IHBLT) is the primary approach to reduce weight gain and improve body mass index (BMI) in children over the age of 6 years old. It is time-intensive, with a direct correlation of effectiveness based on time (hours). Longitudinal care providing ≥ 26 hours over a 3-12 month time period is the minimum, and interventions ≥ 52 hours provided the most significant reduction in BMI and improvements in cardiometabolic health.  

• Name the three Rotterdam criteria (2 of 3 required for diagnosis).
• A patient with PCOS has increased or decreased amounts of sex hormone binding globulin?
•  What is the most sensitive test to diagnose insulin resistance in those with PCOS?
• What benefits does combined estrogen-progestin oral contraceptive provide in those with PCOS?
• What benefits does metformin and spironolactone have in those with PCOS?

Sample Question Explanation: This patient diagnosed with PCOS who is seeking treatment should be initiated on the first-line treatment which is a combined estrogen-progestin oral contraceptive (OCP). The benefits include endometrial protection in the setting of anovulation (progestin), contraceptive protection for those not seeking pregnancy, and improvement of hyperandrogenic manifestations.

• What are some of the causes of telogen effluvium?
• What is the physiology of this condition?
• What mineral deficiency can lead to alopecia and anosmia?

Sample Question Explanation: This patient who is presenting after surgery with hair loss, despite taking appropriate vitamin supplementation, is likely experiencing telogen effluvium. This condition causes diffuse non-scarring hair loss due to the hair cells synchronizing into the telogen (resting) phase after a significant stressor which includes surgery and significant weight loss. Most cases are reversible and only require reassurance.  

• What is the definition of a metabolic equivalent task (MET)?
• What formula estimates the number of calories utilized per minute?
• How many METs correspond with vigorous-intensity activity?
•   Bicycling at more than 8 MPH is considered what intensity of physical activity?
• Memorize the table at the bottom of the blog!

Sample Question Explanation: Moderate-intensity activities include activities that are between 3 to 6 metabolic equivalents (METS), which includes brisk walking (2.5- 4 MPH), playing tennis, recreational swimming, and bicycling less than 10 MPH. 

Note: Be familiar with the activities and their MET values. Numerous exercise questions will be seen on the examination!

Next Week: Endoscopic gastroplasty

Upcoming: Cohen's syndrome, hormonally active adipose, and metabolic syndrome

For more practice questions, check out the following: 

• Obesity Medicine Board Review Questions (2024) 
• Obesity Medicine Practice Tests (2024)

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Copyediting by Kelly Smith

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