A 55-year-old woman has morbid obesity, uncontrolled T2DM, ischemic heart disease and bilateral osteoarthritis. On examination, her vitals are normal, BMI 33. She has no signs of hypothyroidism or Cushing's. She wants to lose weight and improve her HbA1c control as it is 8.5% now. She has tried many diet regimens but with no significant weight loss. Which of the following is the best treatment option?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Liraglutide
With BMI 33 plus obesity-related comorbidities (T2DM, IHD, OA) after failed diet, she qualifies for pharmacotherapy (BMI ≥27 with comorbidities), not surgery (needs BMI ≥35 with complications or ≥40). A GLP-1 agonist such as liraglutide is first-line and also improves HbA1c.
- Orlistat is weaker and does not help glycaemia; phentermine is a sympathomimetic, unsuitable with IHD; sleeve gastrectomy is not yet indicated at BMI 33.
ليش كل خيار صح أو غلط
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A
ليش غلط
Orlistat (a pancreatic lipase inhibitor) is only an other option; a GLP-1 agonist is the first-line drug for most patients.
✓ Step Up To Medicine 6th Edition 2024 (Obesity).pdf · p. 2 -
B
ليش صح
When diet and exercise are insufficient, a GLP-1 agonist (semaglutide or liraglutide) is first-line therapy for most patients.
✓ Step Up To Medicine 6th Edition 2024 (Obesity).pdf · p. 2 -
C
ليش غلط
Phentermine (a sympathomimetic appetite suppressant, used with topiramate) is listed only as an other option, behind GLP-1 agonists.
✓ Step Up To Medicine 6th Edition 2024 (Obesity).pdf · p. 2 -
D
ليش غلط
Surgery is considered at BMI 35 or more with obesity-related complications (or 40 or more otherwise healthy); her BMI is 33, so drug therapy comes first.
✓ Obesity Disease 4th year September 2024 Alim and Binhussain.pdf · p. 18
- المصدر
- Obesity Disease 4th year September 2024 Alim and Binhussain.pdf · p. 18
Step Up To Medicine 6th Edition 2024 (Obesity).pdf · p. 2 - المحاضرة
- Obesity & Lipids · Endocrinology · Module B
- ظهر في
- Endo bank