Orthopaedic Nurses Certification Board (ONCB) Metabolic/Inflammatory/Tumors Practice Exam

What is a recognized risk factor for the development of osteomalacia in a patient who has undergone gastric bypass surgery?

1. Excessive sunlight exposure

2. Gastric bypass surgery

3. Unmanaged hypertension

4. Sickle cell disease

The correct answer is: Gastric bypass surgery

Gastric bypass surgery is a recognized risk factor for the development of osteomalacia primarily due to potential malabsorption issues that arise post-surgery. This type of surgery alters the gastrointestinal tract, often leading to a reduced ability to absorb essential nutrients, including vitamin D, calcium, and phosphorus. Vitamin D is particularly crucial for maintaining bone health, as it plays a pivotal role in calcium absorption and metabolism. Without adequate levels of vitamin D, calcium cannot be effectively utilized, leading to weak bones and potentially resulting in osteomalacia. In patients who have had gastric bypass surgery, there's often a need for lifelong monitoring of nutrient levels and the potential for supplementation to prevent deficiencies that could lead to osteomalacia. Factors such as excessive sunlight exposure do not contribute to the development of osteomalacia, as sunlight is actually beneficial for vitamin D synthesis. Similarly, unmanaged hypertension and sickle cell disease are not direct factors related to the development of osteomalacia in the context of gastric bypass. Managing the dietary and nutritional aspects after surgery is essential to mitigate these risks.