Bariatric Surgery Flashcards Preview

Gastroenterology > Bariatric Surgery > Flashcards

Flashcards in Bariatric Surgery Deck (32):
1

What comorbidities must be present for a BMI of 30-34.9 to be a candidate for bariatric surgery?

uncontrollable Type 2 DM and metabolic syndrome

2

Psych disorders that are contraindications for bariatric surgery

bulemia, major depression, psychosis, substance abuse

3

Age range to qualify for bariatric surgery

between 18-65

4

Most common bariatric surgeries in order of prevelance

Roux-en Y gastric bypass (47%), sleeve gastrectomy (28%), and Lap. band surgery (18%)

5

Involves the creation of a small gastric pouch and an anastomosis to a Roux limb of jejunum that bypasses 75-150 cm of small bowel

Roux-en Y gastric bypass

6

Characterized by lightheadedness, nausea, diaphoresis and/or abdominal pain, and diarrhea. Result of eating high sugar meal after gastrojejunostomy

dumping syndrome

7

Hormonal alterations that result in decreased appetitie after gastrojejunostomy

ghrelin inhibition and increased GLP-1/CCK

8

Majority of greater curvature of stomach is removed and a tubular stomach is created. More resistant to stretching due to absence of fundus

sleeve gastrectomy

9

Compartmentalizes the upper stomach by placing an adjustable tight band around entrance to the stomach taht is connected to a subcutaneous infusion port.

lap. band surgery

10

Bariatric surgery with the lowest mortality rate

lap band

11

Major vital signs to monitor post surgery.

hypoglycemia and hypotension

12

How often should BP and weight be checked post operatively?

every 4-6 weeks for the first 6 months. Then at 9 and 12 months post surgery

13

Which type of surgery doesn't cause significant macronutrient deficiencies?

Roux-en Y gastric bypass

14

Deficiency associated with lap band surgery

folate

15

Deficiency associated with sleeve gastrectomy

B12

16

Type of formulations of medications that should be used postoperatively

crush or liquid. Insulin instead of oral antidiabetics

17

What class of medications should be avoided postoperatively?

NSAIDs

18

Average caloric intake for the first month after surgery

400-800 kcal diet/day

19

T/F Improvement in DM control happens regardless of the amount of weight lost

true

20

Gastric pouch severe distention secondary to mechanical obstruction or paralytic ileus. Progressive distention and rupture. May be fatal

Gastric remnant distention

21

Sx include: hiccups, LUQ tympany, shoulder pain, abdominal distention, tachycardia, SOB, large gastric bubble on xray

gastric remnant distention

22

After several weeks post-op may present with N/V, dysphagia, GE reflux, inability to tolerate oral intake

stomal stenosis

23

Occur near the gastrojejunostomy. Acid injury to the jejunum or associated with gastrogastric fistula

marginal ulcers

24

Sx include: RUQ pain that lasts longer the 6 hrs and starts post eating, worse with deep inspiration, shoulder pain, N/V, fever,

Acute cholecystitis/cholelithiasis

25

Cause of mesenteric swirl

internal hernia

26

Results in severe micro and macronutrient deficiencies. In severe cases may require intestinal transplantation

short bowel syndrome

27

May be secondary to insulinoma. May be secondary to islet cell hypertrophy. Slowing food transit time may resolve the symptoms

severe hypoglycemia

28

Changes in bowel habits associated with the different surgeries

RYGB often has diarrhea. Constipation seen post gastric banding

29

What would be the diagnosis if you had a gastric band patient who came in with persistent nausea, vomiting and inability to tolerate secretions or oral intake?

stomal obstruction

30

Treatment for stomal obstruction

NG tube to decompress until edema subsides or surgery for band revision

31

What would be the diagnosis if you had a gastric band patient who came in 2yrs post surgery with infection, failure of weight loss, N/V, epigastric pain, hematemesis?

band erosion

32

What are the most common complications of sleeve gastrectomies?

GERD, bleeding, stenosis of stoma, and leaks***