Weight Loss Surgery Ultimate 3 — Questions and Answers
Question 1: Which lab value is most important to monitor for bone health in long-term bariatric surgery follow-up?
- Serum sodium
- Calcium and vitamin D levels (Correct answer)
- Blood urea nitrogen (BUN)
- Serum potassium
Correct answer: Calcium and vitamin D levels
Calcium and vitamin D deficiency are common after bariatric surgery, leading to metabolic bone disease and increased fracture risk if not monitored.
Question 2: What is the primary mechanism by which sleeve gastrectomy promotes weight loss?
- Malabsorption of nutrients
- Restriction of stomach volume and reduction of ghrelin (Correct answer)
- Bypassing the duodenum
- Implanting a foreign device to limit intake
Correct answer: Restriction of stomach volume and reduction of ghrelin
Sleeve gastrectomy removes about 80% of the stomach, reducing capacity and lowering ghrelin (hunger hormone) levels by removing the gastric fundus.
Question 3: Postoperative iron deficiency after bariatric surgery is MOST common in which patient population?
- Elderly men over 65
- Premenopausal women (Correct answer)
- Postmenopausal women
- Adolescent males
Correct answer: Premenopausal women
Premenopausal women are at highest risk for iron deficiency after bariatric surgery due to menstrual blood loss combined with reduced iron absorption.
Question 4: Which bariatric procedure carries the highest risk of nutritional deficiencies due to its extensive malabsorptive component?
- Adjustable gastric band
- Sleeve gastrectomy
- Roux-en-Y gastric bypass
- Biliopancreatic diversion with duodenal switch (BPD/DS) (Correct answer)
Correct answer: Biliopancreatic diversion with duodenal switch (BPD/DS)
BPD/DS bypasses most of the small intestine, causing the most severe malabsorption and requiring the most intensive lifelong supplementation.
Question 5: What is 'pouch dilation' in the context of gastric bypass surgery?
- Enlargement of the bypassed stomach remnant
- Stretching of the small gastric pouch created during surgery (Correct answer)
- Expansion of the duodenum
- Widening of the anastomosis connection
Correct answer: Stretching of the small gastric pouch created during surgery
Pouch dilation occurs when the small gastric pouch stretches over time, usually due to overeating, reducing restriction and contributing to weight regain.
Question 6: Which symptom is a hallmark of 'late dumping syndrome' occurring 1–3 hours after eating?
- Bloating and constipation
- Hypoglycemia with sweating and confusion (Correct answer)
- Severe acid reflux
- Pain at the surgical incision site
Correct answer: Hypoglycemia with sweating and confusion
Late dumping syndrome is caused by reactive hypoglycemia from excessive insulin release following rapid glucose absorption, presenting with diaphoresis and neurological symptoms.
Question 7: A patient post-gastric bypass develops tingling in hands and feet. Which deficiency should be suspected first?
- Vitamin A
- Zinc
- Thiamine (Vitamin B1) or B12 (Correct answer)
- Magnesium
Correct answer: Thiamine (Vitamin B1) or B12
Peripheral neuropathy after bariatric surgery is most commonly linked to thiamine (B1) or B12 deficiency, both of which impair nerve function.
Weight Loss Surgery Ultimate 3
Which lab value is most important to monitor for bone health in long-term bariatric surgery follow-up?