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nutr 3330 midterm > bariatric surgery > Flashcards

bariatric surgery Flashcards

1
Q

obesity increases risk of _______

A

multiple co-morbidities

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2
Q

what is obesity

A

accumulation of fat stores

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3
Q

obesity causes a ________ state

A

pro-inflammatory

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4
Q

what is the formula for BMI

A

weight(kg) / height (m)^2

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5
Q

why is central obesity more detrimental to health

A

added stress on vital organs

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6
Q

what is the criteria for bariatric surgery

A

> 18yrs old
BMI > 30kg/m^2
absence of : eating disorder, major psychiatric diagnosis, use of tobacco and other controlled substances
failure of non-surgical attempts at weight loss

this is a last resort for weight loss

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7
Q

what branch of medicine deals with management of body weight

A

bariatric

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8
Q

bariatric surgery can result in numerous post-surgery complications…what is one of the biggest/most important complication

A

macronutrient and micronutrient deficiencies

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9
Q

how does bariatric surgery affect food consumption and energy intake

A

it reduces it

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10
Q

up to what % can gastric capacity be reduced to

A

95%

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11
Q

bariatric surgery compromises _______ and ______ of nutrients.
What does this induce and why

A

digestion and absorption

this induces malabsorption due to anatomical changes that bypass major nutrient absorptive sites in SI

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12
Q

how much does bariatric surgery reduce BW

A

35-65% of baseline

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13
Q

bariatric surgery _____ co-morbidities such as diabetes, hyperlipidemia, hypertension

A

resolves

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14
Q

does the current infastructure in Canada support the growing demand for bariatric surgery?

A

no

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15
Q

what are the three types of bariatric surgery

A 
restrictive
malabsorptive
combined (restrictive and malabsorptive)
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16
Q

outline restrictive bariatric surgery

A
  • reduced total capacity of stomach

- promotes satiety with very little food intake

17
Q

outline malabsorptive bariatric surgery

A
  • changes anatomy of the stomach and SI

- changes digestion and absorption of nutrients

18
Q

outline combined bariatric surgery

A

-combination of stomach restriction and change in anatomy of SI

19
Q

what is the most common type of bariatric surgery

A

combined (restrictive and malabsoptive)

20
Q

what are three types of RESTRICTIVE surgery

A
  • Vertical banded Gastroplasty
  • fixed gastric banding
  • adjustable gastric banding
21
Q

what is the most commonly performed gastric bypass and bariatric surgery

A

Roux-en-gastric bypass (RYGP)

22
Q

outline RYGP (Roux-en-gastric bypass)

A
  • mixed restrictive and malabsorptive
  • most common gastric bypass and bariatric surgery
  • stomahc and duodenum are pratically excluded from digestion
  • small pouch is created and connected to part of jejunum
  • can be used as a second surgery if sufficient weight loss does not occur with first
23
Q

what are the key micronutrient issues with bariatric surgery

A

-primarily due to combination of decreased intake and decreased absorption
(could also consume and absorb but cant use it)

  • also due to poor compliance to supplements
    • poor tolerance, depression, cost

(iron, B12, folate, thiamin, Vit D and Ca)

24
Q

what is the most common miconutrient deficiency after bypass surgery

A

IRON

Possible exam question

25
Q

what are the reasons for a iron deficiency after bypass surgery (need to know at least 3 reasons)

A
  • reduced intake of heme iron; poor tolerance to meat consumption (this already give 2 reasons….less uptake and less absorption)
  • surgery causes bypass site for absorption (less absorption)
  • reduced HCl in stomach to reduce ferric iron to ferrous iron for absorption (reduced ferrous iron is better absorbed)
  • low compliance with iron supplementation (poor digestive tolerance to oral iron supplements, supplements can cause gastric irritation of the newly created pouch)
  • could also be partly bc of GI blood loss during surgery
26
Q

what should the iron deficient patient take to maintain iron stores after bypass surgery

A

iron supplementation

27
Q

what is another common complication of bariatric surgery (besides iron)

A

-Vitamin B12

28
Q

what deficiency is common with Roux-en-Y gastric bypass

A

Vit B12

29
Q

what is the reasons for a B12 deficiency after bariatric surgery

A
  • reduced Gastric acid produced from the newly created small pouch (inadequate to cleave B12 from animal protein)
  • decreased intrinsic factor (key for B12 deficiency)
  • limited meat intake due to poor tolerance
30
Q

which is a more common bariatric complication/deficiency, folate or B12

A

B12

31
Q

what is the primary reason for a folate deficiency after bariatric surgery

A

poor intake…..absorption is okay

easy to prevent with a supplement

32
Q

what is done to prevent a folate bariatric complication

A

a supplement is always included

33
Q

list the possible deficiencies of bariatric surgery

A
  • Iron (#1)
  • B12
  • Folate
  • Thiamin
  • Vit D and Ca
  • zinc
  • copper
  • fat soluble vitamins
34
Q

which deficiency is the most common pre-existing deficiency of obese patients (before surgery)

A

Vit D

35
Q

is a Vit D deficiency corrected or worsened after surgery/weight loss?

A

worsened…theres a lot of Vit D in fat stores

36
Q

what is the least tolerated food in Roux-en-Y patients

A

milk

37
Q

is a Vit E deficiency common after bariatric surgery?

A

no

38
Q

what are two micronutrients supplemented after bariatric surgery?

A

zinc, copper

39
Q

what micronutrients are rarely an issue in bariatric surgery complications

A

riboflavin
B6
Vit C
Vit E

multi vitamin and mineral supplements are routinely given before and after bariatric surgery

nutr 3330 midterm (13 decks)

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