Outline the key issues in the post-operative management of a super-obese (BMI 59) patient with type 2 diabetes following sleeve gastrectomy.
Maintain euglycaemia (BSL 4-10)
Avoid starvation ketosis
Additional Examiners’ Comments:
Candidates who scored well mentioned specific challenges and considerations (rather than just generic “ABCs”) and suggested strategies to address these.
The best resource for this was actually the UpToDate article on bariatric surgery. The college answer had some fairly generic suggestions (eg. "Monitoring of vital signs", "appropriate diet commenced as soon as practical") - as if without such recommendations the trainees would leave their bariatric patients unfed and unmonitored.
In trying to separate these generic issues from the real unique problems of post-operative care for the super-obese patient, the following summary was formed:
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