Weight Loss Surgery Pre-Surgery Preparation and Candidacy 2 — Questions and Answers
Question 1: Why is a sleep study (polysomnography) commonly required in the pre-operative evaluation for bariatric surgery?
- To assess anesthesia dosing only
- To detect and manage obstructive sleep apnea before surgery (Correct answer)
- To evaluate insomnia caused by depression
- To screen for narcolepsy
Correct answer: To detect and manage obstructive sleep apnea before surgery
Obstructive sleep apnea is prevalent in bariatric patients and must be identified and managed pre-operatively to reduce anesthesia and respiratory risks.
Question 2: Which nutritional deficiency is most critical to screen for before bariatric surgery, particularly for patients planning a malabsorptive procedure?
- Vitamin C
- Iron and vitamin B12 (Correct answer)
- Vitamin K
- Zinc
Correct answer: Iron and vitamin B12
Iron and vitamin B12 deficiencies are common before surgery in obese patients and can be severely worsened by malabsorptive procedures like Roux-en-Y gastric bypass.
Question 3: Which multidisciplinary team member is primarily responsible for assessing a patient's dietary habits and educating them about post-surgical eating requirements?
- Bariatric surgeon
- Registered dietitian (Correct answer)
- Endocrinologist
- Physical therapist
Correct answer: Registered dietitian
A registered dietitian evaluates nutritional status, counsels the patient on dietary changes, and helps plan the post-operative eating progression.
Question 4: What is the typical minimum smoking cessation period required before most bariatric surgery programs will proceed with surgery?
- 2 weeks
- 4 weeks
- 6 weeks (Correct answer)
- 3 months
Correct answer: 6 weeks
Most programs require at least 6 weeks of smoking cessation before surgery, as smoking significantly increases the risk of anastomotic leaks and pulmonary complications.
Question 5: Which blood panel component is most important for detecting metabolic syndrome as part of bariatric pre-operative testing?
- Complete blood count (CBC)
- Fasting glucose and HbA1c (Correct answer)
- Liver function tests only
- Prothrombin time (PT/INR)
Correct answer: Fasting glucose and HbA1c
Fasting glucose and HbA1c levels identify diabetes and insulin resistance, which are core features of metabolic syndrome requiring optimization before surgery.
Question 6: What is the primary reason bariatric programs require patients to attend pre-operative education seminars?
- To meet insurance billing requirements
- To ensure informed consent and realistic expectations about outcomes (Correct answer)
- To assess the patient's IQ
- To train patients in self-injection techniques
Correct answer: To ensure informed consent and realistic expectations about outcomes
Pre-operative education ensures patients have realistic expectations, understand the risks and lifestyle changes required, and can provide true informed consent.
Question 7: Which imaging study is most often used to evaluate liver size and detect fatty liver disease before bariatric surgery?
- MRI of the liver
- Abdominal ultrasound (Correct answer)
- CT scan with contrast
- HIDA scan
Correct answer: Abdominal ultrasound
Abdominal ultrasound is the most commonly used, cost-effective imaging modality to assess liver size, echogenicity, and detect hepatic steatosis pre-operatively.
Weight Loss Surgery Pre-Surgery Preparation and Candidacy 2
Why is a sleep study (polysomnography) commonly required in the pre-operative evaluation for bariatric surgery?