CSOWM COMPREHENSIVE EXAMS SET 2026
SOLVED QUESTIONS
●● Which of the following procedures is being used increasingly in the
US as definitive treatment for severe obesity (eg, in patients with a body
mass index [BMI] > 60)?
a. Sleeve Gastrectomy
b. Roux-en Y Gastric Bypass
c. Adjustable Gastric Banding
d. Vertical Banded Gastroplasty. Answer: Answer: A: Sleeve
gastrectomy; because this procedure causes substantial and sustained
weight loss, it is being used increasingly in the US as definitive
treatment for severe obesity. Part of the stomach is removed, creating a
tubular stomach passage. The procedure does not involve anatomic
changes to the small intestine. B: Nonetheless, Roux-en-Y gastric bypass
surgery accounts for about 80% of bariatric procedures in the US. C:
Use of adjustable gastric banding has dramatically decreased in the US.
D: Vertical banded gastroplasty is no longer commonly done because
complication rates are high and the resulting weight loss is insufficient.
●● Contraindications to bariatric surgery include which of the
following?
a. Body mass index (BMI) < 30 kg/m2
b. Current drug or alcohol abuse
c. Obstructive sleep apnea
,d. High-risk lipid profile. Answer: Answer: B: Current drug or alcohol
abuse. A: The use of bariatric surgery is controversial in patients with a
BMI < 30. C and D: To qualify for bariatric surgery, patients should have
a BMI of > 40 or a BMI of > 35 plus a serious complication (eg,
diabetes, hypertension, obstructive sleep apnea [C], high-risk lipid
profile [D]).
●● Bariatric Surgery Key Points. Answer: Consider weight loss surgery
if patients are motivated, have not succeeded using nonsurgical
treatments, and have a BMI of > 40 kg/m2 or a BMI of > 35 kg/m2 plus
a serious complication (eg, diabetes, hypertension, obstructive sleep
apnea, high-risk lipid profile) or a BMI of 30 to 34.9 with type 2
diabetes and inadequate glycemic control despite optimal lifestyle and
medical therapy.
Weight loss surgery is contraindicated if patients have an uncontrolled
psychiatric disorder (eg, major depression), drug or alcohol abuse,
cancer that is not in remission, or another life-threatening disorder or if
they cannot comply with nutritional requirements (including life-long
vitamin replacement when indicated).
The most common procedures are sleeve gastrectomy and Roux-en-Y
gastric bypass; use of adjustable gastric banding has decreased
dramatically in the US.
Monitor patients regularly after surgery for maintenance of weight loss,
resolution of weight-related comorbid disorders, and complications of
,surgery (eg, nutritional deficiencies, metabolic bone disease, gout,
cholelithiasis, nephrolithiasis, depression, alcohol abuse).
●● Which of the following increases the risk of cardiovascular disorders
in patients with obesity?
a. Osteoporosis
b. Excess abdominal fat
c. Psychological disorders
d. Gastric Ulcer. Answer: Answer: B: Excess abdominal fat.
Complications, including coronary artery disease, are more likely in
patients with fat that is concentrated abdominally. Choices A, C, and D
do not increase the risk of cardiovascular disorders in patients with
obesity.
●● What is the role of ghrelin in food intake-regulating pathways?
a. It increases food intake.
b. It decreases food intake.
c. Level decreases when weight is lost.
d. It integrates energy balance signals.. Answer: Answer: A: Ghrelin,
secreted primarily by the stomach, increases food intake. B, C, and D:
Other hormones and regulatory substances have these effects.
●● Which type of exercise is MOST effective for increasing BMR?
a. Aerobic exercise
, b. Resistance exercise
c. Balancing exercise
d. Flexibility exercise. Answer: Answer: B: Resistance (strengthening)
exercises are the most effective way to increase BMR. Resistance
exercises increase muscle mass. Because muscle tissue burns more
calories at rest than does fat tissue, increasing muscle mass produces
lasting increases in BMR. Choices A, C, and D can also be effective in a
weight management program. A combination of aerobic and resistance
exercise is better than either alone, particularly when patients choose
activities they enjoy.
●● Obesity Key Points. Answer: Obesity increases the risk of many
common health problems and causes up to 300,000 premature deaths
each year in the US, making it second only to cigarette smoking as a
preventable cause of death.
Excess caloric intake and too little physical activity contribute the most
to obesity, but genetic susceptibility and various disorders (including
eating disorders) may also contribute.
Screen patients using BMI and waist circumference and, when body
composition analysis is indicated, by measuring skinfold thickness or
using bioelectrical impedance analysis.
SOLVED QUESTIONS
●● Which of the following procedures is being used increasingly in the
US as definitive treatment for severe obesity (eg, in patients with a body
mass index [BMI] > 60)?
a. Sleeve Gastrectomy
b. Roux-en Y Gastric Bypass
c. Adjustable Gastric Banding
d. Vertical Banded Gastroplasty. Answer: Answer: A: Sleeve
gastrectomy; because this procedure causes substantial and sustained
weight loss, it is being used increasingly in the US as definitive
treatment for severe obesity. Part of the stomach is removed, creating a
tubular stomach passage. The procedure does not involve anatomic
changes to the small intestine. B: Nonetheless, Roux-en-Y gastric bypass
surgery accounts for about 80% of bariatric procedures in the US. C:
Use of adjustable gastric banding has dramatically decreased in the US.
D: Vertical banded gastroplasty is no longer commonly done because
complication rates are high and the resulting weight loss is insufficient.
●● Contraindications to bariatric surgery include which of the
following?
a. Body mass index (BMI) < 30 kg/m2
b. Current drug or alcohol abuse
c. Obstructive sleep apnea
,d. High-risk lipid profile. Answer: Answer: B: Current drug or alcohol
abuse. A: The use of bariatric surgery is controversial in patients with a
BMI < 30. C and D: To qualify for bariatric surgery, patients should have
a BMI of > 40 or a BMI of > 35 plus a serious complication (eg,
diabetes, hypertension, obstructive sleep apnea [C], high-risk lipid
profile [D]).
●● Bariatric Surgery Key Points. Answer: Consider weight loss surgery
if patients are motivated, have not succeeded using nonsurgical
treatments, and have a BMI of > 40 kg/m2 or a BMI of > 35 kg/m2 plus
a serious complication (eg, diabetes, hypertension, obstructive sleep
apnea, high-risk lipid profile) or a BMI of 30 to 34.9 with type 2
diabetes and inadequate glycemic control despite optimal lifestyle and
medical therapy.
Weight loss surgery is contraindicated if patients have an uncontrolled
psychiatric disorder (eg, major depression), drug or alcohol abuse,
cancer that is not in remission, or another life-threatening disorder or if
they cannot comply with nutritional requirements (including life-long
vitamin replacement when indicated).
The most common procedures are sleeve gastrectomy and Roux-en-Y
gastric bypass; use of adjustable gastric banding has decreased
dramatically in the US.
Monitor patients regularly after surgery for maintenance of weight loss,
resolution of weight-related comorbid disorders, and complications of
,surgery (eg, nutritional deficiencies, metabolic bone disease, gout,
cholelithiasis, nephrolithiasis, depression, alcohol abuse).
●● Which of the following increases the risk of cardiovascular disorders
in patients with obesity?
a. Osteoporosis
b. Excess abdominal fat
c. Psychological disorders
d. Gastric Ulcer. Answer: Answer: B: Excess abdominal fat.
Complications, including coronary artery disease, are more likely in
patients with fat that is concentrated abdominally. Choices A, C, and D
do not increase the risk of cardiovascular disorders in patients with
obesity.
●● What is the role of ghrelin in food intake-regulating pathways?
a. It increases food intake.
b. It decreases food intake.
c. Level decreases when weight is lost.
d. It integrates energy balance signals.. Answer: Answer: A: Ghrelin,
secreted primarily by the stomach, increases food intake. B, C, and D:
Other hormones and regulatory substances have these effects.
●● Which type of exercise is MOST effective for increasing BMR?
a. Aerobic exercise
, b. Resistance exercise
c. Balancing exercise
d. Flexibility exercise. Answer: Answer: B: Resistance (strengthening)
exercises are the most effective way to increase BMR. Resistance
exercises increase muscle mass. Because muscle tissue burns more
calories at rest than does fat tissue, increasing muscle mass produces
lasting increases in BMR. Choices A, C, and D can also be effective in a
weight management program. A combination of aerobic and resistance
exercise is better than either alone, particularly when patients choose
activities they enjoy.
●● Obesity Key Points. Answer: Obesity increases the risk of many
common health problems and causes up to 300,000 premature deaths
each year in the US, making it second only to cigarette smoking as a
preventable cause of death.
Excess caloric intake and too little physical activity contribute the most
to obesity, but genetic susceptibility and various disorders (including
eating disorders) may also contribute.
Screen patients using BMI and waist circumference and, when body
composition analysis is indicated, by measuring skinfold thickness or
using bioelectrical impedance analysis.
