Case history #1. An 8-year-old white girl presents for further evaluation of excessive weight gain

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. Overweight, particularly …individuals past middle life, is a burden which many persons carry about quite without necessity.

a. at

b. on

c. from

d. by

e. in

2. In many instances, this heavy burden will result in a definite shortening of the normal life span; they … to premature death from coronary thrombosis, from diabetes, or from infections, such as pneumonia or cholecystitis, as well as many other diseases, than persons in the same age group whose weight is average or below average.

a. are more likely to succumb

b. are more likely to be succumb

c. are more likely to be being succumb

d. is more likely to succumb

e. am more likely to succumb

3. …, the obese individual suffers from unnecessary fatigue, from heat intolerance, and from arthritis, as well as from other serious discomforts, much more commonly than do persons of normal weight.

a. Further

b. Furthermost

c. Furtherance

d. Furthermore

e. Furthest

4. Thus, the prevention of obesity and the retention of normal weight is a matter of importance in the field of….

a. prenatal medicine

b. preventive medicine

c. physical medicine

d. postclinical medicine

e. preserving medicine

5. The important factor in production of overweight is a daily caloric intake which exceeds the energy requirement of the body — in brief; the fat person eats … rich food.

a. too many

b. too little

c. too small

d. too big

e. too much

6. A positive energy balance … a variety of causes: one of the important factors is dietary habits.

a. might be due to

b. may be due to

c. may due to

d. may to be due to

e. may be due

7. People … eat as much as they did at 20, although their activities are greatly curtailed. Probably the most common cause of overweight is the fact that individuals overeat because they enjoy food, and do not realize that there is any risk in overindulgence.

a. over 20

b. over 30

c. over 40

d. over 50

e. over 60

8. Prevention of overweight centers … each individual that overweight, particularly with increasing age, is an unnecessary hazard to a normal life.

a. teaching

b. is teaching

c. be teaching

d. to be teaching

e. is being teaching

9. The person must be convinced that the … with increasing age is injurious, in a direct ratio to the degree of increase of weight to increasing age.

a. "increased" gain of weight

b. "permanent" gain of weight

c. "normal" gain of weight

d. "gradual" gain of weight

e. "decreased" gain of weight

10. The other essential educational feature that must be emphasized is that weight reduction … by maintaining a slow and gradually progressive negative energy balance.

a. can best be secured

b. could best be secured

c. can best is secured

d. can worst be secured

e. can best to be secured

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