Lecture 31 - Bariatric Surgery

Question 1

The relative risk for men with BMI greater than or equal to 35 of developing DM2 is ____, while women with the same BMI have relative risk of _____.

Answer 1

42

93

Question 2

Visceral fat around the _______ in obese people is thought it induce Metabolic syndrome.

Answer 2

Intestines

Question 3

A Mayo study found weight loss of 7% of body weight in high risk patients decreased risk of DM2 by ____%.

Answer 3

60%

Question 4

FDA requires weight loss drugs to produce a min loss of ___% of body weight to be approved for market.

Answer 4

5%

Question 5

Orlistat offers 3-8% weight loss by acting as an inhibitor of pancreatic _____.

Answer 5

Lipase

Question 6

Sibutramine is an ______ suppressor that acts via ______ reuptake inhibition. It offers dose-dependent weight loss of up to 7-8% at 2 years.

Answer 6

Appetite suppressor

Monamine

Question 7

______ is a weight loss drug only approved for short-term use, and it acts on the Hypothalamus.

Answer 7

Phentermine

Question 8

What are the BMI guidelines for patients to qualify for bariatric surgery?

Answer 8

BMI of 35 or greater with comorbidities OR BMI greater than 40

Question 9

____-__-___ Gastric Bypass surgery is the gold standard for bariatric surgery. It connects the _____ to a small stomach puch, thus bypassing the duodenum.

Answer 9

Roux-en-Y

Jejunum

Question 10

Patients can experience weight loss of up to _____ of total weight post Roux-en-Y bypass. They cannot consume _____ and _____ together. They can experience dumping if they consume too many simple ____ too quickly. They need vitamin supp such as _____, _____, and _____.

Answer 10

1/3

Solids and Liquids

Simple Carbs

Calcium, Fe, and VitB12

Question 11

Because the small stomach pouch connects directly to the Jejunum, Roux-en-Y patients can develop ______ ulcers, particularly with smoking or _____ use.

Answer 11

Marginal ulcers

NSAID

Question 12

One of the main issues with Lap Band surgery is the possibility for slippage of the stomach up through the band. Why is this problematic?

Answer 12

The portion of the stomach that slips up through will then have restricted blood supply –> ischemia and necrosis

Question 13

Vertical sleeve gastrectomy (removal of about 90% of stomach is removed and remaining is stapled back up) is typically performed in patients greater than ____ lbs. Patients can lose up to 1/4 of their bodyweight.

Answer 13

600lbs

Question 14

Put the following in order of most weight loss to least weight loss:

Sleeve Gastrectomy

Gastric Bypass

Laproscopic banding

Answer 14

Gastric Bypass > Sleeve > Band

Keep in mind Sleeve gastrectomy is most commonly performed

Question 15

Ideal bod weight = 50kg + (2.3 x________)

Answer 15

of inches over 5ft

Question 16

Excess weight = ______ - ______

Answer 16

Actual - Ideal

Question 17

Gastric bypass reduces specific-cause mortality by the following % for the following 3 diseases:

____ –> reduced by 56%

____ –> reduced by 92%

____ –> reduced by 60%

Answer 17

CAD

DM2

Cancer

Question 18

Two important aspects of patients losing weight before their bariatric surgery are demonstrating ______ and reduction of _____ size (makes acessing the stomach and duodenum easier).

Answer 18

Motivation

Liver

Question 19

Follow-up schedule post-surgery for gastric surgery patients is once at ____ months, again at ____ months, again at ____ months, and then ______ from then on.

Answer 19

3

6

9

Annually

Question 20

All of the following are Relative Contraindications for Bariatric Surg:

Severe _____ failure

Unstable _____ ____ disease

End-stage _____ disease

Active ______ diagnosis/treatment

______ with portal HTN

Uncontrolled _____ or _____ dependency

Severely impaired ______ capacity.

Answer 20

Heart

Coronary Artery

Renal

Cancer

Cirrhosis

Drug or Alcohol

Intellectual