CSOWM CONTINUATION OF CARE DOMAIN
EXAM 2026/2027 QUESTIONS WITH
CORRECT SOLUTIONS
Instructions: This exam contains multiple-choice questions covering the
Continuation of Care domain of the CSOWM examination. Topics include
interdisciplinary coordination, treatment plan development, follow-up and
evaluation, and long-term management of obesity.
1. A patient who underwent Roux-en-Y gastric bypass 8 years ago
presents with night blindness and dry skin. She reports poor adherence
to her multivitamin regimen. Which deficiency is most likely?
A. Vitamin B12
B. Vitamin A
C. Thiamine
D. Iron
Correct Answer: B — Vitamin A
Rationale: Vitamin A deficiency is a known long-term complication of
malabsorptive bariatric procedures such as RYGB. Symptoms include
,night blindness (nyctalopia) and dry, scaly skin. Poor adherence to
bariatric-specific multivitamins is a common contributing factor.
Treatment includes high-dose oral vitamin A supplementation with
regular monitoring of serum retinol and liver function tests to avoid
hypervitaminosis A .
2. A patient 6 months post-Roux-en-Y gastric bypass presents with
fatigue, glossitis, and elevated MCV. Which deficiency is most likely?
A. Vitamin D
B. Iron
C. Thiamine
D. Vitamin B12
Correct Answer: D — Vitamin B12
Rationale: Post-RYGB patients are at high risk for B12 deficiency due to
reduced intrinsic factor and decreased absorption in the terminal ileum,
leading to macrocytic anemia, glossitis, and neurologic symptoms .
, 3. A patient 2 weeks post-bariatric surgery is vomiting and cannot
tolerate oral intake. Which deficiency is most time-sensitive to prevent
neurologic damage?
A. Vitamin A
B. Thiamine (B1)
C. Vitamin D
D. Iron
Correct Answer: B — Thiamine (B1)
Rationale: Thiamine stores deplete quickly (within weeks). Post-
operative vomiting dramatically increases risk of Wernicke-Korsakoff
syndrome, making it the most urgent deficiency. IV thiamine must be
given before any carbohydrate administration .
4. Which micronutrient deficiency is most associated with
biliopancreatic diversion procedures?
A. Vitamin K
B. Fat-soluble vitamins (A, D, E, K)
EXAM 2026/2027 QUESTIONS WITH
CORRECT SOLUTIONS
Instructions: This exam contains multiple-choice questions covering the
Continuation of Care domain of the CSOWM examination. Topics include
interdisciplinary coordination, treatment plan development, follow-up and
evaluation, and long-term management of obesity.
1. A patient who underwent Roux-en-Y gastric bypass 8 years ago
presents with night blindness and dry skin. She reports poor adherence
to her multivitamin regimen. Which deficiency is most likely?
A. Vitamin B12
B. Vitamin A
C. Thiamine
D. Iron
Correct Answer: B — Vitamin A
Rationale: Vitamin A deficiency is a known long-term complication of
malabsorptive bariatric procedures such as RYGB. Symptoms include
,night blindness (nyctalopia) and dry, scaly skin. Poor adherence to
bariatric-specific multivitamins is a common contributing factor.
Treatment includes high-dose oral vitamin A supplementation with
regular monitoring of serum retinol and liver function tests to avoid
hypervitaminosis A .
2. A patient 6 months post-Roux-en-Y gastric bypass presents with
fatigue, glossitis, and elevated MCV. Which deficiency is most likely?
A. Vitamin D
B. Iron
C. Thiamine
D. Vitamin B12
Correct Answer: D — Vitamin B12
Rationale: Post-RYGB patients are at high risk for B12 deficiency due to
reduced intrinsic factor and decreased absorption in the terminal ileum,
leading to macrocytic anemia, glossitis, and neurologic symptoms .
, 3. A patient 2 weeks post-bariatric surgery is vomiting and cannot
tolerate oral intake. Which deficiency is most time-sensitive to prevent
neurologic damage?
A. Vitamin A
B. Thiamine (B1)
C. Vitamin D
D. Iron
Correct Answer: B — Thiamine (B1)
Rationale: Thiamine stores deplete quickly (within weeks). Post-
operative vomiting dramatically increases risk of Wernicke-Korsakoff
syndrome, making it the most urgent deficiency. IV thiamine must be
given before any carbohydrate administration .
4. Which micronutrient deficiency is most associated with
biliopancreatic diversion procedures?
A. Vitamin K
B. Fat-soluble vitamins (A, D, E, K)
