RCE Exam Questions With Revised Correct Detailed Answers With Rationales Guaranteed Pass
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Course
RCES
Institution
RCES
RCE Exam Questions With Revised
Correct Detailed Answers With
Rationales
Guaranteed Pass
1) What is the pathophys of malabsorption in ZES?
Gastric Acid volume cannot be reabsorbed by SB or CLN -Gastric acid overcomes pancreatic bicarb neutralizing capacty -->low pH --> panc enzyme...
-Gastric acid impairs Na & water absorption
2) How does SIBO cause malabsorption?
1. CHO
-bacteria damage enterocyte --> impairs disaccharidase &
monosaccarhide transport
2. Fat
-bacteria deconjugate bile acids & decrease normal bile acid pool
3. Protein
-damagse to the epithelial barrier
,-increased intestinal permeability,
decreased mucosal uptake of amino acids,
-intraluminal degradation of protein precursors by bacteria
3) How does TI disease cause malabsorption?
Decreased reabsorption of bile salt malabsorption
--> decreased normal bile salt pool
How does short bowel syndrome cause malabsorption?
1. Length of bowel
2. Site of resection
Ileal
-B12 malabsorption
-Bile salt malabsorption
-loss of ileal cecal calve
4) What are the etiologies for SIBO?
1. Impaired motility
-IBS
-Narcotics
-Pseuoobstruction
-DM
2. Structural
-Adhesions
-IBD
-Tumours
3. Immune disorders
,-HIV
-CVID
-IgA defic
4. Gastric hypochlorhydria
Why is B12 malabsorbed in
1. SIBO
2. ZES
3. Pancreatic insufficiency
4. Gastric surgery
1. SIBO
-anaerobes utilize B12 coupled with IF, competing for absorption
3. Panc Insufficiency
-enzymes dissociate B12 from salivary & food proteins --> allow it to
bind to IF
4. Gastric Surgery
absence of gastric acid & pepsin --> impaired liberation of vitamin B12
from food proteins,
-->the reduced production of intrinsic factor by parietal cells
What metabolites are elevated in B12 deficiency?
-Methylmalonic acid
-Homocysteine
, What are the RF for microscopic colitis?
Meds:
NSAIDS
Lansoprazole
Statins
H2 blockers
SSRIs
Pembrolizumab
Smoking
Female & > 50
What are the treatments for microsopic colitis?
1. Stop offending medication
2. Imodium prn
3. Budesonide 8-12 weeks, then taper q2 weeks
4. Cholestyramine 4 g QID
5. Bismuth Subsalicylate
6. Anti-TNFS, AZA, 6-MCP
7. Resection
What factors increase/decrease chance of HCV clearance/SVR?
SVR = undetectable HCV RNA @ 6 mos after tx completion
Increase
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