1. Recognition of various nutritional deficiencies is crucial in a postbariatric patient. Identify the wrong association between the symptoms and the deficient micronutrient. A. Bleeding tendency – vitamin E B. Tongue soreness, appetite loss, and constipation – vitamin B12 C. Bullous-pustular dermatitis – zinc D. Posterolateral myelopathy – copper 2. A 45-year-old male 6 months s/p RYGB presents with a 25-hydroxy vitamin D level of 15 (normal > 32 ng/mL) and PTH of 85 (Normal 10 to 55 pg/mL). He seems very compliant and reports that he is currently taking a supplement containing 500-mg calcium citrate and 500 IU of vitamin D twice daily and a multivitamin with iron at least 2 hours apart from the calcium with vitamin D. The patient lives in an area where there is ample sunlight round the year. What would be the BEST recommendation for this patient? A. Double his current dosage of calcium citrate. B. Prescribe 1000 IU of vitamin D daily. C. Sit in the sun for 1 hour daily and drink a few glasses of milk daily. D. Prescribe 50,000 IU of vitamin D to be taken once weekly, and recheck labs again in 3 months. E. Confirm vitamin D deficiency with measurement of 1,25-dihydroxycholecalciferol (DHCC) levels.
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1. Recognition of various nutritional deficiencies is crucial in a postbariatric patient. Identify..