RT Book, Section
A1 McConkey, Stacy
A1 Fals, Angela M.
A2 Usatine, Richard P.
A2 Sabella, Camille
A2 Smith, Mindy Ann
A2 Mayeaux, E.J.
A2 Chumley, Heidi S.
A2 Appachi, Elumalai
SR Print(0)
ID 1114879340
T1 Obesity
T2 The Color Atlas of Pediatrics
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-176701-9
LK accesspediatrics.mhmedical.com/content.aspx?aid=1114879340
RD 2024/04/23
AB A  13-year-old  Hispanic  female  is  brought  to  her  pediatrician  with  various  concerns,  including  that  her  neck  always  appearing  dirty  no  matter  how  much  she  washes  and  scrubs  it.  The  pediatrician  notes  that  the  child  has  acanthosis  nigricans  of  the  neck  and  axillae  along  with  obesity  (Figure  194-1).  The  mother  is  obese  and  admits  to  having  type  2  diabetes.  A  diet  history  reveals  that  the  mother  cooks  traditional  Mexican  cuisine  and  the  daughter  is  very  fond  of  tortillas.  She  also  loves  to  eat  pizza,  french  fries,  and  other  fast  food.  The  girl  is  a  good  student  but  does  not  like  to  exercise  or  play  sports.  The  pediatrician  is  concerned  that  the  girl  may  have  insulin  resistance  or  type  2  diabetes  so  she  plans  to  send  the  patient  for  screening  labs  including  hemoglobin  A1c  and  fasting  blood  sugar.  She  also  recommends  a  healthier  diet  with  less  calories  and  increased  physical  activity.  A  referral  to  a  nutritionist  is  offered.