MKSAP: 55-year-old woman after bariatric surgery

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old woman is evaluated during a routine examination. She underwent biliopancreatic diversion with duodenal switch 8 years ago for treatment of obesity-related complications and lost 68.0 kg (150.0 lb) in the first year following surgery. Her weight has been relatively stable for the last year. She has had chronic nonbloody diarrhea since her bariatric surgery. She also has had generalized fatigue, dry skin, dry and itchy eyes, and increased difficulty seeing road signs at night while driving. Her other medical problems are type 2 diabetes mellitus and hypertension. Her prescription medications are metformin and lisinopril, and she also takes an over-the-counter multivitamin with iron. Her last colonoscopy, performed 5 years ago, was normal. On physical examination, blood pressure is 140/79 mm Hg and pulse rate is 63/min. BMI is 25. The examination is otherwise unremarkable. Laboratory studies reveal a hemoglobin level of 10.5 g/dL (105 g/L) and a mean corpuscular volume of 95 fL. Which of the following deficiencies best explains this patient’s current findings? A. Copper B. Iron C. Vitamin A D. Vitamin B12 Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Gastroenterology Source Type: blogs