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NBME 20 Answers

nbme20/Block 4/Question#44

A 45-year-old man comes to the office for ...

Starchy foods

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 +5  upvote downvote
submitted by thepacksurvives(5),

I think this one has to do with "late dumping syndrome"-- basically, starchy foods cause hyperglycemia --> release of insulin --> catecholamine surge --> diarrhea, etc.

 +2  upvote downvote
submitted by beeip(56),

Thought this would be something regarding "bariatric surgery," but nope, just "no starchy foods, because you're pre-diabetic."

hello  Yep, seems that because the patient has prediabetes, he should avoid eating excessive starchy foods. +  
yotsubato  such a BS question IMO +2  
yotsubato  such a BS question IMO +  
breis  I put nuts thinking of "fats" and that with a bariatric surgery they may have problems with absorption.. +1  
teetime  This isn't right because the bariatric surgery will cure the prediabetes. It's dumping. +  
dr_jan_itor  Why should he avoid eating excessive starchy foods? To avoid gaining weight? It doesn't matter what macronutrients he eats if they are calorie controlled. +  

 +2  upvote downvote
submitted by strugglebus(60),

I had put "starches" b/c pts that undergo bariatric surgery are only supposed to eat complex carbs (fruits/vegetables) and avoid simple carbs (i.e. breakfast cereal/baked goods)