CBC Bariatric Surgical Procedures Questions and Answers

Question 1

Which bariatric procedure functions primarily through restriction of food intake and does NOT involve intestinal bypass, thereby minimizing the risk of nutrient malabsorption?

Accepted Answer

Laparoscopic Sleeve Gastrectomy (LSG)

Answer

Laparoscopic Sleeve Gastrectomy involves removing a large portion of the stomach to create a smaller, banana-shaped stomach or 'sleeve'. This procedure is purely restrictive, as it reduces the amount of food the stomach can hold. Unlike RYGB, BPD/DS, and SADI-S, it does not alter the path of the small intestine, meaning nutrient absorption remains largely intact.

Question 2

A patient who underwent a Roux-en-Y Gastric Bypass (RYGB) 6 weeks ago calls the clinic in distress. They report experiencing nausea, cramping, sweating, and rapid heartbeat about 20 minutes after eating a small piece of birthday cake. As a Certified Bariatric Counselor, you should recognize these symptoms as characteristic of:

Accepted Answer

Early dumping syndrome

Answer

Early dumping syndrome occurs when sugary or high-fat foods move too quickly from the small stomach pouch into the small intestine. This rapid transit pulls fluid into the intestine, causing symptoms like cramping, nausea, sweating, and palpitations within 30-60 minutes of eating. Late dumping syndrome occurs 1-3 hours after eating and is related to reactive hypoglycemia. Staple line leaks and strictures present with different symptoms, such as severe abdominal pain, fever, or vomiting.

Question 3

The Biliopancreatic Diversion with Duodenal Switch (BPD/DS) offers the highest potential for weight loss but also carries the greatest risk for which of the following long-term complications?

Accepted Answer

Severe protein-calorie malnutrition and vitamin deficiencies

Answer

The BPD/DS is the most malabsorptive of the common bariatric procedures, bypassing a significant portion of the small intestine. This leads to a substantial decrease in the absorption of calories, fats, and essential nutrients, creating a high risk for severe and lifelong protein malnutrition and deficiencies in fat-soluble vitamins (A, D, E, K) and other micronutrients.

Question 4

A client who had an adjustable gastric band (Lap-Band) placed several years ago is experiencing inadequate weight loss and has developed significant acid reflux. They are considering a revisional procedure. Which of the following is a common and effective surgical conversion from a gastric band?

Accepted Answer

Conversion to a Sleeve Gastrectomy or Gastric Bypass

Answer

Due to complications like band slippage, erosion, inadequate weight loss, or severe GERD, gastric bands may be removed. A common next step is a conversion to a more effective procedure like the Sleeve Gastrectomy or Roux-en-Y Gastric Bypass, which addresses weight loss through different and more permanent mechanisms.

Question 5

Which newer bariatric procedure combines a sleeve gastrectomy with a loop of small intestine connected to the duodenum, creating both restrictive and malabsorptive effects with a single intestinal connection (anastomosis)?

Accepted Answer

Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S)

Answer

The SADI-S procedure involves creating a sleeve gastrectomy and then attaching a loop of the ileum (the lower part of the small intestine) to the duodenum. This design, with only one new intestinal connection, is simpler than the traditional BPD/DS while still providing significant restrictive and malabsorptive effects for weight loss and comorbidity resolution.

(CBC) Certified Bariatric Counselor Practice Test

(CBC) Certified Bariatric Counselor Practice Test

CBC Bariatric Surgical Procedures Questions and Answers