Obesity (part 2)

Dyslipidemia is a major component of the criteria for the metabolic syndrome (see “PHATS” mnemonic).

A rule of thumb for the lifestyle recommendations for the treatment of dyslipidemia is “0-5-30”

Zero cigarettes

Five servings of fruits/vegetables per day

Thirty minutes of moderate to vigorous physical activity per day (minimum 150 minutes per week)

 

Click here for some great pocket guides published by the Canadian Cardiovascular Society!

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Psychiatry review of systems

How do you do a “head to toe” assessment for a psychiatric problem? Apart from ensuring that their symptoms are not secondary to a medical illness, you will want to screen for other psychiatric disorders during your interview. The AAFP has a summary article about the psychiatry interview and they suggest the following mnemonic: “Depressed Patients Seem Anxious, SClaim Psychiatrists”

D = Depression and other mood disorders (e.g. bipolar, dysthymia)

P = Personality disorders (e.g. borderline personality disorder, obsessive compulsive personality disorder, etc.)

S = Substance abuse disorder

A = Anxiety disorders (general anxiety disorder, panic disorder, obsessive-compulsive disorder)

S = Somatization disorder and/or eating disorder

C = Cognitive disorder (dementia, delay, delirium)

P = Psychotic disorder (schizophrenia, mood disorder with psychotic features)

 

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ABCDEs of Diabetes

How do you provide care to the diabetic patient in the outpatient setting? The Canadian Diabetes Association suggests the “ABCDEs”:

A = A1C                             i.e. provide optimal control of blood glucose levels by aiming for HbA1C < 7.0%

B = BP                                 i.e. provide optimal control of blood pressure by aiming for pressure of <130/80 (as opposed to 140/90                                                   in non-diabetics)

C = Cholesterol               i.e. maintain the LDL less than 2.0 mmol/L

D = Drugs                          i.e. provide medications for cardioprotection (ACEI and ARBs)

E = Exercise/Eating     i.e. encourage healthy eating and physical activity in all patients for maintenance of a healthy body weight

S = Smoking                     i.e. encourage smoking cessation

Visit the Canadian Diabetes Association website:

http://guidelines.diabetes.ca/VascularProtection/ABCDEs

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