Question

Case Scenario Holly is a 22 year old woman who had a gastric bypass (Roux-en Y) procedure three months ago to assist her in managing her weight. She is being seen in clinic for her routine 3 month post-operative visit. Patient had presented for an initial consult to discuss the possibility of weight loss surgery ~ 4 months prior to her gastric bypass. At that time her past medical history was reviewed and included the following diagnoses: morbid obesity, hypothyroidism and hypertension. Medications included: Levothyroxine - 50 mcg/day, and Carvedilol – 1.75 mcg/day. Patient's anthropometric measurements were as follows: Ht. = 5'8", Wt. = 277 lbs., BMI = 42, BF% = 44. Vitals: blood pressure = 132/96 Patient's anthropometric measurements at her 3 month post-operative visit are as follows: Ht = 5'8', Wt. = 197 lbs., BMI = 30, BF% = 33. Total weight loss since her initial consultation = 80 lbs. Vitals: blood pressure = 124/80 Patient reports that she is still taking her Levothyroxine - 50 mcg/day, however, is no longer taking any blood pressure medication.

Answer 1

3.The following micronutrients deficiency can be seen in this patient are

• Deficiency of vitamin A, can cause vision disturbances ,night blindness
• Deficiency of vitamin D can lead to brittle and porous bones called as osteoporosis ,metabolic bone disorders
• Deficiency of iron, folate due to poor intestinal absorption can lead to iron deficiency anemia
• Deficiency of folate and vitamin B12 can cause peripheral neuropathy
• Vitamin B1 deficiency can leads to Wernick encephalopathy
• Stomatitis, inflammation of the tongue due to lack of vitamin C, vitamin B2, vitamin B6,Zinc
• Niacin deficiency causes skin disorder
• Altered motor function due to lack of copper,vitamin B1 and B2