Bariatric Surgery MCQs

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22 Questions

What is the recommended blood test for patients at baseline?

Full blood count, urea and electrolytes, liver function tests, thyroid function tests, and ferritin

Which vitamin should be checked annually after gastric bypass or sleeve gastrectomy?

Vitamin B12

What is the recommended frequency for checking liver function tests after gastric banding?

Annually

What is the likely diagnosis of the female patient who presented with polyneuropathy and severe paraesthesia after gastric bypass?

Vitamin B12 deficiency

Which of the following tests is not recommended at baseline?

Zinc levels

What is the recommended frequency for checking parathyroid hormone levels after gastric bypass or sleeve gastrectomy?

At 3, 6, 12 months, then annually

According to NICE guidelines, who should be considered for bariatric surgery?

Patients with severe obesity in whom all non-surgical measures have been tried with no adequate weight loss achieved or maintained

What is the estimated percentage of people fulfilling the eligibility criteria who would have no medical or psychological reason why they would not be fit for surgery?

80%

What is the main cause of death after surgery?

DVT/PE

Why is multidisciplinary assessment important?

To improve patient outcomes

What is the advantage of high-volume, specialized units?

Improved patient outcomes

What is the estimated percentage of people fulfilling the eligibility criteria who might want bariatric surgery?

10%

What is the purpose of biochemical guidance after bariatric surgery?

To guide medication adjustment

Why is surgery cost-effective?

Because medications reduce or stop as glycaemic control improves

What is the typical weight loss for most obese people in the short term?

6-8% body weight

What happens to the basal metabolic rate with dieting?

It decreases

What is the long-term weight loss maintenance achieved with bariatric surgery?

15-25% weight loss

What is the term that refers to the marked effects of some operations on diabetes and the metabolic syndrome?

Metabolic surgery

What is included in the metabolic syndrome?

Type 2 diabetes, high blood pressure, dyslipidaemia

Why is the improvement in type 2 diabetes with bariatric surgery important?

It is additional to weight loss

What is the benefit of bariatric surgery on obesity-related disease?

It improves it

What is the term that refers to the condition that is becoming the plague of the 21st century?

Obesity

Study Notes

Defining Severe and Complex Obesity

  • Obesity is becoming a major health issue in the 21st century
  • Dieting and lifestyle interventions can lead to 6-8% weight loss in the short term, but most people regain weight due to decreased basal metabolic rate
  • No pharmacotherapy is currently safe and effective for long-term weight loss

Rationale for Surgery

  • Bariatric surgery can alter the metabolic rate and lead to long-term weight loss maintenance (15-25% weight loss up to 20 years)
  • Surgery improves obesity-related diseases and quality of life, and leads to long-term survival benefit

Metabolic Surgery

  • Metabolic syndrome includes Type 2 diabetes, high blood pressure, dyslipidaemia, and polycystic ovary syndrome
  • Surgery can improve Type 2 diabetes, which may be additional to weight loss
  • Improved glycaemic control reduces medication needs, making surgery cost-effective

Eligibility and NICE Guidelines

  • NICE recommends bariatric surgery for people with severe obesity who have tried non-surgical measures with no adequate weight loss
  • Eligible patients have a high rate of remission or improvement in Type 2 diabetes
  • About 80% of eligible patients have no medical or psychological reasons why they would not be fit for surgery

Multidisciplinary Assessment

  • Every patient should be assessed and managed by a multidisciplinary team of healthcare professionals
  • Improved outcomes are achieved in high-volume, specialized units

Common Operations and Complications

  • Operation choice is guided by patient, surgeon, and unit preferences
  • Complications include DVT/PE, anastomotic leakage, and bleeding
  • Prophylaxis is usually used for at least 1 week to prevent complications

Follow-up and Biochemical Monitoring

  • Annual blood tests include full blood count, urea and electrolytes, liver function tests, and more
  • Additional tests are required for gastric bypass, sleeve gastrectomy, and BPD/DS patients

Assess your knowledge of bariatric surgery, including severe obesity, eligibility, surgical operations, and post-operative care. Test your understanding of this complex topic.

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