Test 12

Question 1

Obesity

Answer 1

Morbid obesity is associated with an increased risk of complications in joint replacement surgery. Aggressive weight loss in obese patients with osteoarthritis can provide improved pain control. Weight-loss surgery should be considered for patients with BMI > 40 or with obesity-related comorbidity and BMI > 35.

Question 2

Obesity

Answer 2

Bariatric surgery is recommended to reduce long-term health consequences in obese women who have failed to achieve weight loss with lifestyle modifications. After bariatric surgery, it is recommended that pregnancy be delayed for at least a year to optimize weight loss and stabilize nutritional status.

Question 3

DM

Answer 3

Tight glycemic control in patients with diabetes decreases the risk of micro vascular complications (retinopathy, nephropathy) but has an uncertain effect on macrovascular complications (MI, stroke).

Question 4

Bell’s palsy

Answer 4

Patients who are pregnant or postpartum have an increased risk of Bell palsy, a peripheral neuropathy involving the facial nerve (CN VII). It should be treated with glucocorticoids with or without acyclovir, and patients have an excellent prognosis for full recovery over weeks to a few months.

Question 5

PUD

Answer 5

Patients with persistent sx of PUD, evidence of Helicobacter pylori associated ulcers, or H pylori-associated malignancy should undergo evaluation to determine bacterial eradication. The preferred options include urea breath testing and fecal antigen testing.