NATIONAL OSTEOPOROSIS FOUNDATION OSTEOPOROSIS CLINICAL UPDATES Bariatric Surgery And Skeletal Health CE APPLICATION FORM

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1 NATIONAL OSTEOPOROSIS FOUNDATION OSTEOPOROSIS CLINICAL UPDATES Bariatric Surgery And Skeletal Health CE APPLICATION FORM First Name: Last Name: Mailing Address: City: State: Zip/Postal Code: Country: Phone Number: Address: Please tell us about your practice: (circle all that apply) Degree/Credentials: Densitometrist Doctor of Osteopathy Medical Doctor MS/MPH Nurse Practitioner Registered Dietitian Registered Nurse Occupational Therapist Physician Assistant Pharmacist PhD Physical Therapist Radiology Technician Social Worker Student/Resident/Intern/Fellow Medical Specialty: Dietetics Emergency Medicine Endocrinology Family Practice Geriatrics Internal Medicine Obstetrics and Gynecology Oncology Orthopedics Pain Management Pediatrics Pharmacy Physical Therapy Physiatrist Public Health Radiology Rehabilitation Research Rheumatology Primary Practice Setting: Academic medical center Community/Rural Health Hospital Military/Veteran s Administration Osteoporosis Center Outpatient Care Center Pharmacy Private Practice Rehabilitation Center Radiology/Diagnostic Center Research facility Women s Center After completing this page, complete the post-test found on pages 2-3 and record your answers on the CE Reporting Form found on page 4. Once you have completed the post-test, please fill in your payment information, complete the evaluation on page 5, print/scan and return the form to NOF at: National Osteoporosis Foundation Education Department th Street NW, Suite 850, Washington, DC Fax: Attn: Clinical Updates CE

2 Bariatric Surgery And Skeletal Health Continuing Education Post Test Test Questions: Please re c o rd your answers on the CE Reporting Form found on the next page. 1. For a 55-year-old postmenopausal patient who has had RYGB bariatric surgery and has a current DXA t-score of - 3.2, which of the following would be the most appropriate first step to address low bone mass? A. Prescribe an FDA-approved antiresorptive medication. B. Evaluate and correct all malabsorption-related deficiencies. C. Reanalyze the patient s DXA measurement using the z-score. D. Counsel patient on healthy nutrition and weight control. 2. Which of the following patients is likely to experience the most severe vitamin and mineral insufficiencies following bariatric surgery. A. 35-year-old man who underwent laparoscopic adjustable gastric band (LAGB). B. 28-year-old woman who underwent roux-en-y gastric bypass (RYGB). C. 70-year-old man who underwent biliopancreatic diversion with duodenal switch (BPD/DS). D. 36-year-old woman who underwent laparoscopic sleeve gastrectomy (LSG). 3. Which of the following conditions contributes to bone loss in patients who have undergone RYGB or BPD/DS bariatric surgery? A. Elevated parathyroid hormone. B. Calcium malabsorption. C. Reduced mechanical loading due to weight loss. 4. True or false. When evaluating BMD in premenopausal women and men under age 50 who have undergone bariatric surgery, z-scores should be used rather than t-scores. A. True. B. False. 5. Which of the following is true regarding vitamin d deficiency? A. It is associated with elevated parathyroid hormone (PTH). B. It is associated with metabolic bone diseases such as osteomalacia C. It is prevalent in obese individuals before and after bariatric surgery. 6. Which of the following represents a key issue in managing the care of post-surgical bariatric patients? A. Many patients experience relapse of chronic conditions. B. Lifelong nutritional surveillance and support are required. C. Most patients regain the weight they lost in the year following surgery. D. Patients frequently experience serious side-effects that require surgical revision. 7. Which is the most commonly performed type of bariatric surgery performed in the U.S.? A. Laparoscopic adjustable gastric band (LAGB). B. Biliopancreatic diversion with duodenal switch (BPD/DS). C. Roux-en-y gastric bypass (RYGB). D. Laparoscopic sleeve gastrectomy (LSG).

3 8. For a 35-year-old patient who has had RYGB bariatric surgery and has a current DXA z-score of -2.2, what could be the most likely cause of her low bone mass? A. Primary osteoporosis. B. Nutrient deficiencies. C. Early menopause. D. Age-related bone loss. 9. Following bariatric surgery, which of the following can help patients maintain weight loss and protect bone health? A. Joining a support group B. Nutritional counseling C. Appointment reminders 10. Which of the following disorders has been shown to improve in a significant percentage of patients who have undergone bariatric surgery? A. Vitamin d deficiency. B. Type 2 diabetes. C. BMD at hip.

4 NATIONAL OSTEOPOROSIS FOUNDATION OSTEOPOROSIS CLINICAL UPDATES: Bariatric Surgery And Skeletal Health CE APPLICATION FORM Each participant is eligible for continuing education credit or a certificate of completion upon reading the newsletter, passing the post test with a score of 70% or higher and returning the completed activity evaluation. There is a $10.00 processing fee which can be paid by check or credit card. To receive a continuing education certificate or certificate of completion, complete and send this reporting form and evaluation with payment to the address/fax listed below. After reading each question on the post-test, please circle your best answer: Payment: 1. a b c d 6. a b c d 2. a b c d 7. a b c d 3. a b c d 8. a b c d 4. a b c d 9. a b c d 5. a b c d 10. a b c d Check AmEx MasterCard Visa Name on Card Billing Address Credit Card Number: Expiration Date: Security Code: Mail or Fax this form to: National Osteoporosis Foundation Education Department th Street NW, Suite 850, Washington, DC Fax: Attn: Clinical Updates CE

5 NATIONAL OSTEOPOROSIS FOUNDATION OSTEOPOROSIS CLINICAL UPDATES: Bariatric Surgery And Skeletal Health Educational Objectives Evaluation The educational objectives for this activity are listed below. Please use the following scale to rate how well this educational material enables you to achieve each objective. 1= Strongly Disagree; 2 = Disagree; 3 = Neutral; 4 = Agree; 5 = Strongly Agree Educational Objectives Describe potential negative consequences to bone associated with obesity, weight loss, and bariatric surgery. 2. Identify patients at risk for nutrient deficiencies following bariatric surgery. 3. Specify laboratory tests that are appropriate to assess nutritional and bone health status in bariatric surgery patients. 4. Recommend appropriate nutritional support and supplementation for patients who have undergone bariatric surgery. 5. Plan patient-specific diagnostic and therapeutic approaches to address low bone density following bariatric surgery. Educational Activity Elements 1. Participation in this activity will help me better identify and treat patients with osteoporosis and low bone mass. 2. Material presented promoted improvements and/or quality in healthcare 3. Material presented was organized and easy to follow 4. Topic(s) was relevant and applicable to my practice 5. Course format enhanced achievement of learning objectives 6. The instructional materials were of high quality 7. Teaching and learning methods were effective 8. Learning assessment activities were appropriate 9. Material presented did not promote proprietary interests of a commercial entity As a result of this activity, I will: 1. Identify patients at risk for nutrient deficiencies following bariatric surgery. 2. Will use laboratory tests that are appropriate to assess nutritional and bone health status in bariatric surgery patients. 3. Recommend appropriate nutritional support and supplementation for patients who have undergone bariatric surgery. 4.. Plan patient-specific diagnostic and therapeutic approaches to address low bone density following bariatric surgery. Would you be interested in participating in a follow-up study regarding this newsletter topic? Yes No

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