CBC Post-Surgical Nutritional Care 3 — Questions and Answers
Question 1: A patient 18 months post-bypass reports shakiness, confusion, and hunger 2 hours after a high-carbohydrate meal. What condition should the counselor suspect?
- Late dumping syndrome (reactive hypoglycemia) (Correct answer)
- Early dumping syndrome
- Marginal ulcer
- Lactose intolerance
Correct answer: Late dumping syndrome (reactive hypoglycemia)
Late dumping occurs 1-3 hours after eating when an exaggerated insulin response causes reactive hypoglycemia.
Question 2: Which micronutrient deficiency after bariatric surgery can cause Wernicke encephalopathy if untreated?
- Thiamine (vitamin B1) (Correct answer)
- Vitamin C
- Vitamin K
- Biotin
Correct answer: Thiamine (vitamin B1)
Thiamine deficiency, often triggered by persistent vomiting, can rapidly progress to Wernicke encephalopathy.
Question 3: A counselor notices a patient is consuming milkshakes and melted ice cream to cope with restriction. What is this behavior called?
- Soft calorie or liquid calorie syndrome (eating around the surgery) (Correct answer)
- Dumping syndrome
- Orthorexia
- Nutrient cycling
Correct answer: Soft calorie or liquid calorie syndrome (eating around the surgery)
Consuming calorie-dense liquids bypasses the restrictive effect of surgery and undermines weight loss.
Question 4: How should iron and calcium supplements be scheduled after bariatric surgery?
- Taken at least 2 hours apart because calcium inhibits iron absorption (Correct answer)
- Always taken together to improve absorption
- Both taken only with dairy products
- Alternated weekly to prevent toxicity
Correct answer: Taken at least 2 hours apart because calcium inhibits iron absorption
Calcium competes with iron for absorption, so doses should be separated by about 2 hours.
Question 5: Which eating behavior is most important for preventing food getting stuck after sleeve gastrectomy?
- Chewing thoroughly and eating slowly with small bites (Correct answer)
- Drinking water with every bite
- Eating only cold foods
- Lying down after meals
Correct answer: Chewing thoroughly and eating slowly with small bites
Thorough chewing and slow eating prevent obstruction and discomfort in the narrow sleeve.
Question 6: A patient asks why carbonated beverages are discouraged after bariatric surgery. What is the best response?
- Gas can cause pouch discomfort, bloating, and may encourage pouch stretching over time (Correct answer)
- Carbonation dissolves surgical sutures
- Bubbles neutralize all stomach enzymes
- Carbonated drinks always cause ulcers
Correct answer: Gas can cause pouch discomfort, bloating, and may encourage pouch stretching over time
Carbonation introduces gas that distends the small pouch, causing pain and potentially contributing to stretching.
Question 7: Which lab finding at a 12-month follow-up most suggests inadequate protein intake in a bariatric patient?
- Low serum albumin (Correct answer)
- Elevated hemoglobin A1c
- High serum sodium
- Elevated LDL cholesterol
Correct answer: Low serum albumin
Low albumin reflects protein-energy malnutrition, a key monitoring marker after bariatric surgery.
CBC Post-Surgical Nutritional Care 3
A patient 18 months post-bypass reports shakiness, confusion, and hunger 2 hours after a high-carbohydrate meal.
What condition should the counselor suspect?