CBE CBE Metabolic and Comorbidity Management 2

Question 1

Nonalcoholic fatty liver disease (NAFLD) is common in bariatric surgical candidates. What is the pre-surgery dietary recommendation primarily used to reduce liver size?

Accepted Answer

A low-calorie, low-carbohydrate liver-shrinking diet for 2–4 weeks

Answer

A high-fat ketogenic diet for 8 weeks

Answer

An all-liquid protein diet for 6 months

Answer

Fasting for 72 hours pre-operatively

Question 2

Which micronutrient deficiency is uniquely associated with metabolic bone disease risk after bariatric surgery?

Accepted Answer

Vitamin D and calcium

Answer

Vitamin C and iron only

Answer

Zinc and vitamin A only

Answer

B vitamins exclusively

Question 3

Which bariatric procedure is most associated with dumping syndrome as a metabolic complication?

Accepted Answer

Roux-en-Y gastric bypass (RYGB)

Answer

Sleeve gastrectomy

Answer

Adjustable gastric banding

Answer

Laparoscopic cholecystectomy

Question 4

A patient 2 years post-RYGB reports new-onset polydipsia and polyuria. What should the CBE suspect and recommend?

Accepted Answer

Recurrence or new-onset diabetes — refer for HbA1c and fasting glucose testing

Answer

Normal post-surgical symptoms — reassure the patient

Answer

Urinary tract infection only — recommend antibiotics

Answer

Excess vitamin C intake — reduce supplements

Question 5

Which cardiovascular risk factor remains elevated in bariatric patients despite significant weight loss if not managed?

Accepted Answer

LDL cholesterol, particularly in patients with familial hypercholesterolemia

Answer

Resting heart rate

Answer

Blood viscosity

Answer

Cardiac output

Question 6

What is the relationship between bariatric surgery and polycystic ovary syndrome (PCOS) in female patients?

Accepted Answer

Weight loss after surgery often reduces androgen levels and improves menstrual regularity in women with PCOS

Answer

Bariatric surgery has no effect on hormonal conditions like PCOS

Answer

Surgery worsens PCOS by causing hormonal imbalance

Answer

PCOS is a contraindication to bariatric surgery