obesity

[b]A 14-year-old girl with biliary colic comes into your clinic. Upon review of her record, her BMI is 30, but this is her only complication to date from obesity. Her mother and father both have undergone bariatric surgery and suffered significant complications. She is currently on a diet and exercise plan through her primary care provider’s office, but has not lost weight. She is discouraged and wants treatment, but does not want bariatric surgery. You recommend a Continued focus on diet and exercise alone b Consideration of a GLP-1 Agonist c Bariatric surgery d Delay surgery to age 18 years[/b]

[size=20px]Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns - "The assistant should grasp and laterally retract the posterior wall of the stomach near the greater curvature to ensure no wall of the stomach is folded on itself causing four layers to be included in the staple line. This also prevents the sleeve from twisting as sequential firings take place, resulting in a spiral staple line."[/size]

[size=20px]Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns - "The advantages of this technique are preservation of the pylorus, which prevents the dumping syndrome prevalent in bypass, reduced malabsorption (although nutritional deficiencies remain a challenge), relative simplicity and shorter operative time versus bypass, and fewer postoperative complications than bypass, as there is only one staple line and no new spaces are created for internal hernia. Although weight loss is slightly less than that after bypass, a sleeve can later be converted to bypass if the malabsorptive component is l…

quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "Patient selection is very important and should be a joint decision from a MDT consisting of paediatrician, surgeon, dietician and psychologist. Before decision-making, patients are thoroughly investigated to identify any underlying condition causing obesity, e.g. hypothyroidism or Prader-Willi syndrome (PWS). Investigations also look for any obesity-related co-morbidities. Blood investigations include full blood count, urea and electrolytes, liver function and metabolic profile to look for non-alcoholic hepatic steatosis or type 2 diab…

.

see video link in second post

[size=20px]A 15 yo boy is being considered for surgical treatment of his severe obesity and its comorbidities. The bariatric procedure with the least adverse impact on adolescent bone health is: A Adjustable gastric band B Sleeve gastrectomy C Roux-en-Y gastric bypass D Biliopancreatic Diversion with duodenal switch​[/size]

[size=20px]You are seeing a 17-year old young woman with a body mass index of 54 who underwent laparoscopic sleeve gastrectomy 12 days previously. Her initial postoperative course was uneventful and she was discharged home on postoperative day two. She subsequently presents with gradually worsening left upper quadrant pain, nausea and fever. Her heart rate is 130 bpm, blood pressure is 104/72, respiratory rate is 26 breaths/minute with room air oxygen saturation of 99%. Her abdominal exam reveals mild left sided tenderness and her incisions are unremarkable. Which of the following is the best initial diagnostic study in the patient with pain after sleeve gastrectomy? …

First one with correct answer with justification win. [size=20px]A fifteen-year old female with longstanding obesity and a body mass index (BMI) of 55 presents to your multidisciplinary weight loss center interested in weight loss surgery. Your team endocrinologist performs a metabolic evaluation. A contraindication to a weight loss surgery would be A increased serum leptin. B absent serum leptin. C increased ghrelin. D absent ghrelin. E decreased gastrointestinal peptide levels.[/size]