Bariatric Surgery questions and answers well illustrated.

Bariatric Surgery questions and answers well illustrated. What are some health implications of obesity? - correct answers.Hypertension High blood pressure Coronary heart disease T2DM Gallbladder disease Liver disease (non-alcoholic fatty liver) Osteoarthritis obstructive sleep apnea some cancers: breast, colon and endometrial cancer. Mental health problems, such as low self-esteem and depression. Why is sleep apnea a common implication of obesity? - correct answers.The more fat you have tends to become accumulated around the next which obstructs the airway during sleep. These people stop breathing several times during the night. Can be resolved with surgery in most cases. What is the obesity trend in Canada? - correct answers.25 % of population was obese in 2006 increases with age between 20-65 years of age followed by a decline How much did the risk of death with obesity in Canada increase ? - correct answers.5.1 % 1985 to 9.3% in 2000. What is the economic burden of obesity in Canada? - correct answers.$4.6-7.1 billion Has obesity doubled worldwide since 1980? - correct answers.Yes. How many children <5 years old were overweight in 2011? - correct answers.More than 40 million. What classes of obesity are we dealing with in bariatric surgery? - correct answers.Class 2 and Class 3 What is bariatric surgery? - correct answers.To promote significant weight loss and assist/ improve weight-related comorbidities. What are the indication for bariatric surgery? - correct answers.BMI > 40 BMI > 35 with significant related comorbidities. Acceptable operative risk. Failure of non-surgical weight loss. Well-informed, compliant and motivated patient (has made dietary changes does have healthy diet at baseline) What are some contraindications to bariatric surgery? - correct answers.Active substance abuse (drugs, alcohol) Uncontrolled psychiatric illness Cirrhosis Pulmonary hypertension Severe cardiac and respiratory disease Active pregnancy ( Should not become pregnant for 1-2 years post-surgery.) If you lose weight too fast you can't sustain pregnancy. When should you stop smoking for bariatric surgery? - correct answers.Quit 3 mo. prior surgery. 2 weeks pre-op. is mandatory. Why should you stop smoking before bariatric surgery? - correct answers.It slows down wound healing and ulcer development. What are two type of categories for bariatric surgeries? - correct answers.1. Restrictive procedures 2. Restrictive and malabsorptive procedures What surgeries gall under restrictive procedure? - correct answers.1. Adjustable gastric band (AGB) 2. Sleeve Gastrectomy Describe the adjustable gastric band. - correct answers.1. Reversible (can be removed) 2. Requires frequent adjustments. 3. Unknown durability of the band. 4. Rapid satiety. What kind of complications can occur with the adjustable gastric band? - correct answers.You can vomit if the band is too restricted. It can slip up and down the stomach and up the esophagus. There can be an erosion of the band that eats away at the skin and damages the tissue making it necrotic. If you don't commit to lifestyle change these people don't do as well. How can the gastric band be adjusted? - correct answers.By inflating the balloon with saline solution in band so it tightens the band even more. Describe the sleeve gastrectomy? - correct answers.70 % of the stomach is removed (Decrease HCL and Parietal cells secrete gastric HCL and intrinsic factor in the stomach. Decreased HCL production affects the absorption of iron. The intrinsic factor is necessary for the absorption of B12 vitamins later in the small intestine. The pyloric sphincter and intestines remain intact. Rapid satiety (1 cup in capacity). *5 years later the majority of weight was gained back. Good short but not long term. Describe the Roux-en-Y Gastric bypass (RYGB). - correct answers.New gastric pouch is created, excludes the funds. Bypass of the duodenum and proximal jejenum. Malabsorption of pancreatic and gastric enzymes reach the proximal jejunum at the anastamosis. Rapid satiety. Where does the food pass in a Roux-en-Y Gastric bypass? - correct answers.Alimentary limb, Pancreatic limb joins at the common channel where food and juice come together and this is where you absorb everything. Very important to observe that the food is NOT passing through the pylorus sphincter. It's reconnecting in the intestine which is why this procedure is malabsorptive. Describe the biliopancreatic diversion with duodenal switch. - correct answers.A procedure unique to Quebec. A combination of a sleeve gastrectomy and bowel resection (restrictive component). Common limb (100 cm of the ileum). More malabsorptive than RYGB. Pancreatic and gastric enzymes reach the ileum at the anastomosis. 1 0r 2 stage procedure. More frequent stools. Where does the food pass in a BPD-Ds procedure? - correct answers.From the esophagus, to the stomach, to the terminal/proximal tubule, to the small intestine and then to large intestine. Which procedure the switch or band produces more wt loss? - correct answers.The switch. Which procedure had a resolution of 96% of DM2? - correct answers.The BPD-Ds, in which there was no more pills and insulin. Almost cured of diabetes. When does the most rapid weight loss take place post bariatric surgery? - correct answers.12 months post-op When is the most significant weight loss seen post bariatric surgery? - correct answers.6 months post-op Do many or few individuals arrive to their Ideal Body Weight? - correct answers.Few