Case history #1

An 8-year-old white girl presents for further evaluation of excessive weight gain. She (to bear) at term following a pregnancy complicated by gestational diabetes, and (to have) a birth weight of 4.5 kg. She has a large appetite with excessive calories eaten throughout the day. She has limited activity, and (to watch) 5 to 6 hours of television daily. She (to have)a tonsillectomy and adenoidectomy for obstructive sleep apnoea (a temporary inability to breathe) at 6 years of age. There is an extensive family history of obesity, and her father's BMI is 35 and mother's BMI is 45. The child's height is 143 cm, and weight 80 kg, giving her a BMI of 38.8, which (to be) markedly greater than the 95th percentile for age and gender.

Exercise 9. Make up questions to the underlined words:

Case history #2

A 15-year-old black girl presents for evaluation of irregular periods (нерегулярні місячні) and acne (прищ; запалення сальної залози). Excessive weight gain is not a primary concern of the family, and they feel that she is simply 'big-boned'. However, her weight has been >97th percentile since 5 years of age. Both parents are obese with type 2 diabetes. Her father also has hyperlipidaemia and had a myocardial infarction at 47 years of age. The child drinks at least 5 cans of regular soft drinks (безалкогольні напої) daily and eats at fast food restaurants several times weekly. She has limited physical activity. Her height, weight, and BMI are 168 cm, 121.2 kg, and 42.8, respectively.

Exercise 10. Be ready to speak on the following items:

1. The main causes of childhood obesity.

2. The possible complications of childhood obesity.

3. Preventive measures of childhood obesity.

TEST

1. Childhood obesity is a condition where excess body fat negatively affects …. a child's health or wellbeing.

a). on b). to c). upon d). with e). -------

2. As methods to determine body fat directly are difficult, the diagnosis of obesity is often based on … .

a).MIB b). BMI c).BIM d).HBP e). BMW

3. Childhood obesity however can also lead … life-threatening conditions including  diabetes, high blood pressure, heart disease, sleep problems, cancer, and other disorders.

a).too b). from c). in d). to e). out

4. Childhood obesity … epidemic proportions in 21st century, with rising rates in both the developed and developing world. 

a). have reached b). reached c). had reached

d). to have reached e). has reached

5. Obesity during adolescence … to increase mortality rates during adulthood.

a). found b). been found c). have been found

d). has been found e). has found

6. Currently … of children worldwide are either overweight or obese.

a). 100% b). 10% c). 0.1% d). 0.10% e). 0.001%

7. …. is approved for adolescents older than 16 and works by altering the brain's chemistry and decreasing appetite.

a). Sibutramine b). Orlistat c). phentermine  d). Rimonabant

e). amphetamine

8. … is approved for adolescents older than 12. It works by preventing the absorption of fat in the intestines.

a). Lorcaserin b). Exenatide  c). Sibutramine d). Pramlintide

e). Orlistat

9. … is a disorder characterized by compulsive overeating followed by vomiting: sometimes associated with anxiety about gaining weight.

a).Anorexia b). gestational diabetes c). Bulimia nervosa

d). Tonsillectomy e). type 2 diabetes

10. Studies have shown that overweight children are more likely … to be overweight adults. 

a). grow up b). grew up c). grows up d). to grow up e). to have grown up