**** CCS- Obesity in Adolescent **** - harry206

[ArchivalUser]

Office
*****
COmplete physical (Imp is calculate BMI from height & weight)
BMI more then 95th percentile
look for any sign of congenital anaomolies
look for short stature
*****
cbc
bmp
lft
ua
ekg
tsh
fasting lipid profile
fasting glucose
urine 24 hr cortisol
karyotype (if history or physical suggestive)
GH, prolactin (if suggestive)
calcium, phosphate, PTH (if suggestive)
COunsel patient
counsel family (IMP)
diet low fat, low protein
consult dietecian
consult psych (if eatind disorder suspected)
counsel excercise
*******
Follow up in 4 month
*******
No change in BMI
Sibutramine oral/ orlistat oral
counsel medication adherence
counsel excercise, diet low fat, low protein
follow up in 2 months
******
No change OR BMI more then 40 or wt more then 100% ideal BMI and pt more then 15 yr ---> go for bariatric surgery
consult gastro
consult surgery
admit to ward
pt/inr
ptt

[ArchivalUser]

why low protein diet harry??/

[ArchivalUser]

According to emed:

Protein sparing modified fast can result in rapid decrease in weight, both inpatient and outpatient. This is successfully used by many in childrens and adolescent with obesity.

Plz correct me where i am wrong

This is imp ccs case.
So modify if anything wrong
Thnx

[ArchivalUser]

calorie restricted diet

[ArchivalUser]

how about low carbohydrate diet

The low protein must be really new. Have not heard about it.