Content Objective: Metabolic Syndrome/Obesity/Dyslipidemia

By the end of the Family Medicine Clerkship, the medical student will be able to:

1. Describe metabolic syndrome (association of visceral adipose tissue mass, dyslipidemia, elevated blood pressure and elevated serum glucose.)
2. Identify risk factors leading to development of metabolic syndrome.
3. Counsel patients on possible interventions for prevention of metabolic syndrome.
   
4. List complications of metabolic syndrome.
5. Outline treatment modalities of metabolic syndrome with respect to diet, activity, pharmacological and surgical options.
6. Define the classifications of weight using BMI in adults.
7. Define the classifications of weight using appropriate BMI for age growth chart in children age 2–20.
8. Identify risk factors for obesity.
9. Determine appropriate cost effective investigations for diagnosis and assessment of complications of obesity (hypertension, diabetes, ischemic heart disease, sleep apnea, osteoarthritis.)
10. Describe treatment modalities for obesity including lifestyle modifications, risks and benefits of pharmacological and surgical options.
11. Discuss effect of obesity on patient personal life and assess motivation for change, consider counselling to support change and facilitating access for interventions.
12. Describe the various types of dyslipidemia: hypercholesterolemia, familial hypercholesterolemia, hypertriglyceridemia.
13. Screen appropriate patients for dyslipidemia.
14. Identify causes of dyslipidemia (genetic, dietary, medical conditions and drugs) and counsel or investigate and treat modifiable causes.
15. Identify common complications of:
    • Hypercholesterolemia—increases cardiovascular risk
    • Hypertriglyceridemia—increased cardiovascular risk, pancreatitis
16. Recommend target lipid levels based on overall cardiovascular risk.
17. Describe all treatment modalities (lifestyle, pharmacological) appropriate for target lipid levels.
18. Review smoking status and encourage smoking cessation as appropriate in dyslipidemia.

Mandatory Clinical Encounter

• Obesity

Resources*

• Chatterjee, A et al. Managing Cardiometabolic Risk in Primary Care. Can Fam Physician 2011 58(4):389-93 [PDF - 216 kB]
  
• Cardiovascular Disease Risk, TOP 2019 (note difference between this guideline and CCSV Dyslipidemia guidelines regarding titration of medications)
• Canadian Cardiovascular Society Guidelines of the Management of Dyslipidemia for the Prevention of Cardiovascular Disease 2016 pocket guide (Look also for Canadian Cardiovascular Society Lipids Guidelines App)
• Overweight and Obese Adults: Diagnosis and Management, BCGuidelines.ca 2011
• See also resources under Preventative Health Care

* Where a specific resource is not listed for a particular objective, please refer to recommended general texts/websites. Resources have often been selected from the Clinical Practice Guidelines and Protocols in British Columbia and Alberta’s Towards Optimized Practice Clinical Practice Guidelines. These are often concise summaries of national guidelines.