CBE Postoperative Care & Long-term Monitoring 3

Question 1

A patient who has vomited often for 3 weeks after surgery develops confusion, ataxia and nystagmus. Which deficiency is most likely?

Accepted Answer

Thiamine (B1)

Answer

Thiamine stores run out within weeks of persistent vomiting, which can cause Wernicke encephalopathy.

Question 2

Why are patients at risk of vitamin B12 deficiency after Roux-en-Y gastric bypass?

Accepted Answer

Less gastric acid and intrinsic factor in the pouch

Answer

The small pouch makes little acid and intrinsic factor, both of which are needed to release and absorb B12.

Question 3

Which instruction best improves absorption of an oral iron supplement after bariatric surgery?

Accepted Answer

Take it with vitamin C and at least 2 hours apart from calcium

Answer

Vitamin C improves iron absorption, while calcium competes with it, so the two should be taken separately.

Question 4

Why is calcium citrate preferred over calcium carbonate after gastric bypass?

Accepted Answer

It does not need stomach acid to be absorbed

Answer

Calcium citrate absorbs well in the low-acid setting of the gastric pouch, while carbonate needs acid.

Question 5

What is the usual target serum 25-hydroxyvitamin D level for bariatric patients?

Accepted Answer

Above 30 ng/mL

Answer

Bariatric guidelines aim for 25(OH)D above 30 ng/mL to support calcium absorption and bone health.

CBE - Certified Bariatric Educator Practice Test