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CSOWM PRACTICE REVIEW EXAM QUESTIONS WITH CORRECT ANSWERS
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CSOWM PRACTICE REVIEW EXAM QUESTIONSWITH CORRECT ANSWERS
Roux-en-Y gastric bypass surgery (RYGB) accounts for over 80% of bariatric
procedures in the United States and is typically performed laparoscopically. During
RYGB, a tiny portion of the proximal stomach is separated from the rest, resulting
in a stomach pouch of <30 mL. Which of the following preexisting illnesses is in
remission in up to 62% of patients 6 years after RYGB?
a. Hypertension
b. Diabetes
c. Obesity
d. Obstructive Sleep Apnoea - ANSWER: B: Diabetes is more likely to remit. After
six years, remission rates can reach as high as 62%. A and D: Other comorbid
problems that tend to improve or disappear after bariatric surgery include
cardiovascular risk factors (e.g., dyslipidaemia, hypertension [A], diabetes),
cardiovascular diseases, obstructive sleep apnoea (D), osteoarthritis, and
depression. C: Weight loss with RYGB ranges from 50 to 65% after two years, and
the weight loss can last up to ten years. All-cause mortality falls by 25%, owing
mostly to lower rates of cardiovascular disease and cancer.
Which of the following treatments is increasingly being employed in the United
States as the definitive treatment for severe obesity (e.g., in patients with a body
mass index [BMI] > 60)?
a. Sleeve gastrectomy.
b. Roux-en-Y Gastric Bypass
c. Adjustable Gastric Banding
d. Vertical Banded Gastroplasty - ANSWER Answer: A: Sleeve gastrectomy;
because this technique results in significant and long-term weight loss, it is
increasingly being employed in the United States as the final treatment for severe
obesity. A portion of the stomach is removed, resulting in a tubular stomach
channel. The technique does not include any anatomical modifications to the small
,intestine. B: Nonetheless, Roux-en-Y gastric bypass surgery is responsible for
around 80% of bariatric surgeries in the United States. C: The use of adjustable
gastric banding has significantly decreased in the United States. D: Vertical banded
gastroplasty is no longer widely performed due to high complication rates and
insufficient weight loss.
What are some of the contraindications to bariatric surgery?
a. BMI < 30 kg/m2.
b. Current substance or alcohol abuse
c. Obstructive Sleep Apnoea
d. High-risk lipid profile - ANSWER B: Current substance misuse. A: Bariatric
surgery is contentious for people with a BMI < 30. C and D: Patients who qualify
for bariatric surgery should have a BMI greater than 40 or a BMI greater than 35
plus a significant complication (for example, diabetes, hypertension, obstructive
sleep apnoea [C], high-risk lipid profile [D]).
Bariatric Surgery Key Points - ANSWER Consider weight loss surgery if patients
are motivated, have failed nonsurgical treatments, and have a BMI of > 40 kg/m2
or a BMI of > 35 kg/m2 plus a serious complication (e.g., diabetes, hypertension,
obstructive sleep apnoea, high-risk lipid profile), or a BMI of 30 to 34.9 with type 2
diabetes and inadequate glycaemic control despite optimal lifestyle and medical
therapy.
Weight loss surgery is not recommended if patients have an uncontrolled
psychiatric disorder (e.g., major depression), drug or alcohol abuse, cancer that is
not in remission, or another life-threatening disorder, or if they are unable to meet
nutritional requirements (including lifelong vitamin replacement when indicated).
,The most prevalent surgeries are sleeve gastrectomy and Roux-en-Y gastric bypass;
the usage of adjustable gastric banding has significantly reduced in the United
States.
Patients should be monitored on a frequent basis after surgery to ensure that their
weight loss is maintained, weight-related comorbid problems are resolved, and
surgical complications are avoided.
Which of the following increases the risk of cardiovascular diseases in obese
patients?
a. Osteoporosis
b. Excess belly fat
c. Psychological disorders.
d. Gastric Ulcer - Answer: B: Excess abdominal fat. Patients with accumulated
abdominal fat are more prone to have complications, including coronary artery
disease. Choices A, C, and D do not raise the risk of cardiovascular diseases in
obese persons.
What role does ghrelin play in the pathways that regulate food intake?
a. It boosts food consumption.
b. It reduces food intake.
c. When weight loss occurs, the level lowers.
d. It integrates energy balance signals. - ANSWER: A: The stomach secretes
ghrelin, which promotes food consumption. B, C, and D: Other hormones and
regulatory chemicals have similar effects.
, Which sort of exercise is the most effective at raising BMR?
a. Aerobic workout.
b. Resistance exercise.
c. Balancing exercises
d. Flexibility exercise - ANSWER: B: Resistance (strengthening) activities are the
most effective approach to boost BMR. Resistance exercises build muscle mass.
Muscle tissue burns more calories at rest than fat tissue, hence increasing muscle
mass leads to long-term improvements in BMR. Choices A, C, and D can also be
useful in a weight-management program. A combination of aerobic and resistance
training is preferable than either alone, especially when patients select activities
that they love.
Obesity Key Points - ANSWER Obesity increases the risk of numerous common
health problems and accounts for up to 300,000 premature deaths in the United
States each year, making it the second leading preventable cause of death behind
cigarette smoking.
Obesity is primarily caused by excessive calorie intake and insufficient physical
activity, but genetic vulnerability and different diseases (including eating disorders)
may also play a role.
Patients should be screened using BMI and waist circumference, and if body
composition analysis is required, skinfold thickness or bioelectrical impedance
study.
Obese people should be screened for common comorbidities such as obstructive
sleep apnoea, diabetes, dyslipidaemia, hypertension, fatty liver, and depression.
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