Review Questions to practice for
CSOWM exam with all solution
,Which of the following procedures is
Answer: A: Sleeve gastrectomy; because this procedure
being used increasingly in the US as
causes substantial and sustained weight loss, it is being used
definitive treatment for severe obesity (eg,
increasingly in the US as definitive treatment for severe
in patients with a body mass index [BMI]
obesity. Part of the stomach is removed, creating a tubular
> 60)?
stomach passage. The procedure does not involve
a.Sleeve Gastrectomy
anatomic changes to the small intestine. B: Nonetheless,
b. Roux-en Y Gastric Bypass
Roux-en-Y gastric bypass surgery accounts for about 80% of
c.Adjustable Gastric Banding
bariatric procedures in the US. C: Use of adjustable gastric
d.Vertical Banded Gastroplasty
banding has dramatically decreased in the US. D: Vertical
banded gastroplasty is no longer commonly done
because complication rates are high and the resulting
weight loss is insufficient.
Contraindications to bariatric surgery
Answer: B: Current drug or alcohol abuse. A: The use of
include which of the following?
bariatric surgery is controversial in patients with a BMI < 30.
a.Body mass index (BMI) < 30 kg/m2
C and D: To qualify for bariatric surgery, patients should
b.Current drug or alcohol abuse
have a BMI of > 40 or a BMI of > 35 plus a serious
c. Obstructive sleep apnea
complication (eg, diabetes, hypertension, obstructive sleep
d. High-risk lipid profile
apnea [C], high-risk lipid profile [D]).
Bariatric Surgery Key Points Consider weight loss surgery if patients are motivated, have
not succeeded using nonsurgical treatments, and have a BMI
of > 40 kg/m2 or a BMI of > 35 kg/m2 plus a serious
complication (eg, diabetes, hypertension, obstructive sleep
apnea, high-risk lipid profile) or a BMI of 30 to 34.9 with type 2
diabetes and inadequate glycemic control despite optimal
lifestyle and medical therapy.
Weight loss surgery is contraindicated if patients have an
uncontrolled psychiatric disorder (eg, major depression), drug
or alcohol abuse, cancer that is not in remission, or
another life-threatening disorder or if they cannot comply
with nutritional requirements (including life-long vitamin
replacement when indicated).
The most common procedures are sleeve gastrectomy and
Roux-en-Y gastric bypass; use of adjustable gastric banding
has decreased dramatically in the US.
Monitor patients regularly after surgery for maintenance of
weight loss, resolution of weight-related comorbid disorders,
and complications of surgery (eg, nutritional deficiencies,
metabolic bone disease, gout, cholelithiasis, nephrolithiasis,
depression, alcohol abuse).
Which of the following increases the risk
Answer: B: Excess abdominal fat. Complications, including
of cardiovascular disorders in patients
coronary artery disease, are more likely in patients with
with obesity?
fat that is concentrated abdominally. Choices A, C, and D do
a.Osteoporosis
not increase the risk of cardiovascular disorders in patients
b. Excess abdominal fat
with obesity.
c. Psychological disorders
d. Gastric Ulcer
, What is the role of ghrelin in food intake- Answer: A: Ghrelin, secreted primarily by the stomach,
regulating pathways? increases food intake. B, C, and D: Other hormones
a.It increases food intake. and regulatory substances have these effects.
b. It decreases food intake.
c. Level decreases when weight is lost.
d. It integrates energy balance signals.
Which type of exercise is MOST effective for Answer: B: Resistance (strengthening) exercises are the most
increasing BMR? effective way to increase BMR. Resistance exercises increase
a.Aerobic exercise muscle mass. Because muscle tissue burns more calories at
b. Resistance exercise rest than does fat tissue, increasing muscle mass
c. Balancing exercise produces lasting increases in BMR. Choices A, C, and D
d. Flexibility exercise can also be effective in a weight management program. A
combination of aerobic and resistance exercise is better
than either alone, particularly when patients choose
activities they enjoy.
Obesity Key Points Obesity increases the risk of many common health problems
and causes up to 300,000 premature deaths each year in the
US, making it second only to cigarette smoking as a
preventable cause of death.
Excess caloric intake and too little physical activity contribute
the most to obesity, but genetic susceptibility and various
disorders (including eating disorders) may also contribute.
Screen patients using BMI and waist circumference and,
when body composition analysis is indicated, by measuring
skinfold thickness or using bioelectrical impedance
analysis.
Screen obese patients for common comorbid disorders, such
as obstructive sleep apnea, diabetes, dyslipidemia,
hypertension, fatty liver, and depression.
Encourage patients to lose even 5 to 10% of body weight by
changing their diet, increasing physical activity, and using
behavioral interventions if possible.
Try treating patients with orlistat, phentermine,
phentermine/topiramate, naltrexone/bupropion, liraglutide, or
semaglutide if BMI is ≥ 30 or if BMI is ≥ 27 and they
have complications (eg, hypertension, insulin resistance);
however, for severe obesity, surgery is most effective.
Encourage all patients to exercise, to eat healthily, to get
enough sleep, and to manage stress.
CSOWM exam with all solution
,Which of the following procedures is
Answer: A: Sleeve gastrectomy; because this procedure
being used increasingly in the US as
causes substantial and sustained weight loss, it is being used
definitive treatment for severe obesity (eg,
increasingly in the US as definitive treatment for severe
in patients with a body mass index [BMI]
obesity. Part of the stomach is removed, creating a tubular
> 60)?
stomach passage. The procedure does not involve
a.Sleeve Gastrectomy
anatomic changes to the small intestine. B: Nonetheless,
b. Roux-en Y Gastric Bypass
Roux-en-Y gastric bypass surgery accounts for about 80% of
c.Adjustable Gastric Banding
bariatric procedures in the US. C: Use of adjustable gastric
d.Vertical Banded Gastroplasty
banding has dramatically decreased in the US. D: Vertical
banded gastroplasty is no longer commonly done
because complication rates are high and the resulting
weight loss is insufficient.
Contraindications to bariatric surgery
Answer: B: Current drug or alcohol abuse. A: The use of
include which of the following?
bariatric surgery is controversial in patients with a BMI < 30.
a.Body mass index (BMI) < 30 kg/m2
C and D: To qualify for bariatric surgery, patients should
b.Current drug or alcohol abuse
have a BMI of > 40 or a BMI of > 35 plus a serious
c. Obstructive sleep apnea
complication (eg, diabetes, hypertension, obstructive sleep
d. High-risk lipid profile
apnea [C], high-risk lipid profile [D]).
Bariatric Surgery Key Points Consider weight loss surgery if patients are motivated, have
not succeeded using nonsurgical treatments, and have a BMI
of > 40 kg/m2 or a BMI of > 35 kg/m2 plus a serious
complication (eg, diabetes, hypertension, obstructive sleep
apnea, high-risk lipid profile) or a BMI of 30 to 34.9 with type 2
diabetes and inadequate glycemic control despite optimal
lifestyle and medical therapy.
Weight loss surgery is contraindicated if patients have an
uncontrolled psychiatric disorder (eg, major depression), drug
or alcohol abuse, cancer that is not in remission, or
another life-threatening disorder or if they cannot comply
with nutritional requirements (including life-long vitamin
replacement when indicated).
The most common procedures are sleeve gastrectomy and
Roux-en-Y gastric bypass; use of adjustable gastric banding
has decreased dramatically in the US.
Monitor patients regularly after surgery for maintenance of
weight loss, resolution of weight-related comorbid disorders,
and complications of surgery (eg, nutritional deficiencies,
metabolic bone disease, gout, cholelithiasis, nephrolithiasis,
depression, alcohol abuse).
Which of the following increases the risk
Answer: B: Excess abdominal fat. Complications, including
of cardiovascular disorders in patients
coronary artery disease, are more likely in patients with
with obesity?
fat that is concentrated abdominally. Choices A, C, and D do
a.Osteoporosis
not increase the risk of cardiovascular disorders in patients
b. Excess abdominal fat
with obesity.
c. Psychological disorders
d. Gastric Ulcer
, What is the role of ghrelin in food intake- Answer: A: Ghrelin, secreted primarily by the stomach,
regulating pathways? increases food intake. B, C, and D: Other hormones
a.It increases food intake. and regulatory substances have these effects.
b. It decreases food intake.
c. Level decreases when weight is lost.
d. It integrates energy balance signals.
Which type of exercise is MOST effective for Answer: B: Resistance (strengthening) exercises are the most
increasing BMR? effective way to increase BMR. Resistance exercises increase
a.Aerobic exercise muscle mass. Because muscle tissue burns more calories at
b. Resistance exercise rest than does fat tissue, increasing muscle mass
c. Balancing exercise produces lasting increases in BMR. Choices A, C, and D
d. Flexibility exercise can also be effective in a weight management program. A
combination of aerobic and resistance exercise is better
than either alone, particularly when patients choose
activities they enjoy.
Obesity Key Points Obesity increases the risk of many common health problems
and causes up to 300,000 premature deaths each year in the
US, making it second only to cigarette smoking as a
preventable cause of death.
Excess caloric intake and too little physical activity contribute
the most to obesity, but genetic susceptibility and various
disorders (including eating disorders) may also contribute.
Screen patients using BMI and waist circumference and,
when body composition analysis is indicated, by measuring
skinfold thickness or using bioelectrical impedance
analysis.
Screen obese patients for common comorbid disorders, such
as obstructive sleep apnea, diabetes, dyslipidemia,
hypertension, fatty liver, and depression.
Encourage patients to lose even 5 to 10% of body weight by
changing their diet, increasing physical activity, and using
behavioral interventions if possible.
Try treating patients with orlistat, phentermine,
phentermine/topiramate, naltrexone/bupropion, liraglutide, or
semaglutide if BMI is ≥ 30 or if BMI is ≥ 27 and they
have complications (eg, hypertension, insulin resistance);
however, for severe obesity, surgery is most effective.
Encourage all patients to exercise, to eat healthily, to get
enough sleep, and to manage stress.
