Perioperative guideline Flashcards
what is a common cause of low phosphate post-op?
low Vitamin D
What should be evaluated with significant weight regain, other than the obvious
Gastro-gastric fistula
pouch enlargement
anastomic dilation
inadequate band restriction
Differential for post-prandial hypoglycemic sx not responding to nutritional changes
Noninsulinoma pancreatogenous hypoglycemia syndrome
Dumping syndrome
Insulinoma
Consider 2 diagnoses if difficult to wean off ventilation post op
PE
ANASTOMOTIC LEAK
What dose of ursodeoxycholic acid should be considered post-op?
500 mg QD for SG
300 mg BID for RYGB or DS
What is the cause of loss of BMD in bariatric surgery patient
Increased bone turnover
Target 24hr urinary calcium and 25 OH Vit D
100mg/specimen 24 urine
>30 ng/dL
What is the physiologic abnormality most likely related to increased levels of FFAs in people with increased visceral adiposity,insulin resistance?
Resistance to the appetite regulation effects of leptin.
Why do RNY patients have lower incidence of GERD
Very small pouch= less stomach acid
What is Caprini’s scoring system, and what else is suggested for this problem pre-op?
Looks at risk for DVT
Should measure anti-factor Xa to determine use of unfractionated heparin vs LMWH
What class of drug is Tegludutide, approved for treatment of Short bowel syndrome. And why?
GLP-2 agonist, causes growth of mucosal cells
