CBC Nutritional Science for Bariatrics — Questions and Answers

Question 1: After a Roux-en-Y gastric bypass, which vitamin deficiency is most likely because its absorption depends on intrinsic factor and the bypassed duodenum?

Vitamin C
Vitamin B12 (Correct answer)
Vitamin K
Niacin

Correct answer: Vitamin B12

B12 requires intrinsic factor and the bypassed portions of the stomach and duodenum, so deficiency is common after RYGB.

Question 2: What is the recommended minimum daily protein intake commonly advised for most post-bariatric patients?

20-30 g
40-50 g
60-80 g (Correct answer)
120-150 g

Correct answer: 60-80 g

Guidelines typically recommend 60-80 g of protein daily to preserve lean mass after surgery.

Question 3: Which mineral deficiency after bariatric surgery is a leading cause of anemia, especially in menstruating women?

Iron (Correct answer)
Zinc
Selenium
Magnesium

Correct answer: Iron

Reduced acid and duodenal bypass impair iron absorption, making iron-deficiency anemia common.

Question 4: Why are chewable or liquid vitamin supplements often preferred in the early postoperative period?

They taste better
They are cheaper
They dissolve and absorb more reliably in the smaller stomach (Correct answer)
They contain more calories

Correct answer: They dissolve and absorb more reliably in the smaller stomach

Chewable and liquid forms dissolve more readily and absorb better while the stomach pouch heals.

Question 5: Dumping syndrome after gastric bypass is most commonly triggered by which type of food?

High-fiber vegetables
Lean protein
Simple sugars and refined carbohydrates (Correct answer)
Water between meals

Correct answer: Simple sugars and refined carbohydrates

Rapid entry of simple sugars into the small intestine causes fluid shifts and dumping symptoms.

Question 6: Which fat-soluble vitamins require monitoring particularly after malabsorptive procedures like biliopancreatic diversion?

Vitamins A, D, E, and K (Correct answer)
Vitamins B1, B6, B12
Vitamin C only
Folate and niacin

Correct answer: Vitamins A, D, E, and K

Fat malabsorption reduces uptake of the fat-soluble vitamins A, D, E, and K.

Question 7: What hydration guidance is typically given to bariatric patients regarding fluids and meals?

Drink large amounts during meals
Avoid fluids for 30 minutes before and after meals (Correct answer)
Only drink carbonated beverages
Limit total daily fluids to 500 mL

Correct answer: Avoid fluids for 30 minutes before and after meals

Separating fluids from meals prevents overfilling the pouch and reduces early satiety loss and dumping.

Question 8: Thiamine (B1) deficiency after bariatric surgery can cause which serious neurological condition, especially with persistent vomiting?

Wernicke encephalopathy (Correct answer)
Scurvy
Rickets
Pellagra

Correct answer: Wernicke encephalopathy

Thiamine depletion from vomiting or poor intake can precipitate Wernicke encephalopathy.

Question 9: Which supplement combination should be spaced apart because they compete for absorption?

Calcium and iron (Correct answer)
Protein and water
Vitamin C and iron
Folate and B12

Correct answer: Calcium and iron

Calcium inhibits iron absorption, so these supplements should be taken at separate times.

Question 10: Which form of calcium is preferred after gastric bypass due to reduced stomach acid?

Calcium carbonate
Calcium citrate (Correct answer)
Calcium phosphate
Calcium gluconate

Correct answer: Calcium citrate

Calcium citrate is absorbed well without gastric acid, unlike carbonate.

Question 11: A patient reports hair loss around 3-6 months post-op. Which nutrient inadequacy is a common contributor alongside rapid weight loss?

Excess sodium
Inadequate protein (Correct answer)
Excess vitamin C
High fiber

Correct answer: Inadequate protein

Inadequate protein during rapid weight loss commonly contributes to telogen effluvium hair shedding.

Question 12: Which eating behavior is recommended to prevent overfilling the small gastric pouch?

Eating quickly to finish before satiety
Taking small bites and chewing thoroughly (Correct answer)
Drinking soda with meals
Eating three very large meals daily

Correct answer: Taking small bites and chewing thoroughly

Small bites and thorough chewing prevent obstruction and overfilling of the pouch.

Question 13: Protein sources are prioritized at meals primarily because protein does what?

Provides the most calories per gram
Preserves lean body mass and increases satiety (Correct answer)
Is stored as glycogen
Prevents all vitamin deficiencies

Correct answer: Preserves lean body mass and increases satiety

Adequate protein preserves muscle during weight loss and promotes fullness.

Question 14: Which lab is most appropriate to routinely monitor vitamin D status?

Serum 25-hydroxyvitamin D (Correct answer)
Serum calcium only
Fasting glucose
Serum albumin

Correct answer: Serum 25-hydroxyvitamin D

25-hydroxyvitamin D is the standard marker of vitamin D stores.

Question 15: Which dietary progression stage typically comes immediately after clear liquids following bariatric surgery?

Regular solid foods
Full liquids/pureed foods (Correct answer)
High-fat foods
Raw vegetables

Correct answer: Full liquids/pureed foods

The diet advances from clear liquids to full liquids and pureed foods before soft and solid textures.

Question 16: Zinc deficiency after bariatric surgery may present with which sign?

Night blindness
Impaired wound healing and taste changes (Correct answer)
Bleeding gums
Bone pain

Correct answer: Impaired wound healing and taste changes

Zinc is essential for wound healing and taste, so deficiency causes poor healing and dysgeusia.

Question 17: Why should carbonated beverages generally be discouraged after bariatric surgery?

They are too acidic for teeth
They can cause gas, discomfort, and pouch distension (Correct answer)
They contain intrinsic factor
They improve iron absorption

Correct answer: They can cause gas, discomfort, and pouch distension

Carbonation introduces gas that causes bloating and may distend the small pouch.

Question 18: A patient plateaus in weight loss and reports grazing on small high-calorie snacks. What is the best counseling focus?

Increase carbonated drinks
Structure planned protein-focused meals and reduce grazing (Correct answer)
Skip all meals
Add fried foods for satiety

Correct answer: Structure planned protein-focused meals and reduce grazing

Structured protein-based meals reduce constant calorie intake from grazing and support continued loss.

Question 19: Which condition can result from chronic vitamin D and calcium inadequacy after bariatric surgery?

Metabolic bone disease/osteoporosis (Correct answer)
Hyperthyroidism
Gout
Peptic ulcer

Correct answer: Metabolic bone disease/osteoporosis

Long-term calcium and vitamin D deficiency leads to secondary hyperparathyroidism and bone loss.

Question 20: What is the general recommendation on alcohol for post-bariatric patients?

Alcohol is fully safe in any amount
Alcohol has stronger and faster effects and adds empty calories (Correct answer)
Alcohol improves nutrient absorption
Alcohol should replace water

Correct answer: Alcohol has stronger and faster effects and adds empty calories

After surgery alcohol is absorbed faster with heightened effects and provides empty calories, so caution is advised.

Question 21: Which supplement is generally recommended lifelong for all bariatric surgery patients?

A daily multivitamin with minerals (Correct answer)
High-dose niacin only
No supplements after 1 year
Only vitamin C

Correct answer: A daily multivitamin with minerals

A daily multivitamin with minerals is recommended lifelong to prevent multiple deficiencies.

CBC Nutritional Science for Bariatrics

After a Roux-en-Y gastric bypass, which vitamin deficiency is most likely because its absorption depends on intrinsic factor and the bypassed duodenum?

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