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Gastro > Endoscope and the GI tract > Flashcards

Endoscope and the GI tract Flashcards

1
Q

What are the parts of a basic endoscope

A

Screen, Light source, air/ water, control head and flexible tip

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2
Q

What are some specialised types of endoscope and what do they look at?

A

Gastroscope - Stomach
Colonoscope - Colon
Side viewing ERCP - Some of the organs that come off of the GI tract
Enteroscope - looking at the bit you cant see with the Gastroscope (Small bowel)
Capsule - pill cam
Endoscopic Ultrasound - lumen of the stomach - can scan the organs from inside out

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3
Q

How big are capsule?

A

1-2cm

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4
Q

What are the risks with capsule?

A

They contain a battery which must come out
Difficult to swallow
Relatively expensive

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5
Q

What are the drawbacks of the EUS Scopes

A

Very expensive

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6
Q

What do patients need before an endoscope

A

Sedative or anaesthetic

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7
Q

What are endoscopes used for?

A

Diagnostics - cancer, inflammation and ulcers
Therapeutics - Biopsy abnormalities
Treat things - to stop a bleeding ulcer
Screening - early diagnoses of cancers - Colorectal cancer screening. taking a healthy population to try and pick up pre-malignant cells and cure them
Surveillance - people with an illness that we want to keep an eye on.

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8
Q

What is Barrett’s oesophagus

A

a metaplasia caused by a chemical irritation
cells undergo a metaplastic change to thick, cuboidal cells so that it is more like the stomach, so not as badly effected by acid reflux

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9
Q

What can be diagnosed through visual diagnoses?

A 
Oesophagitis 
Gastritis
Ulceration
Coeliac disease
Crohn's dsease 
Ulcerative colitis 
Sclerosing cholangitis
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10
Q

What are the two different types of tumours

A

Malignant and Benign tumours

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11
Q

What are some vascular abornalities

A

Varices
Ectatic blood vessels (GAVE, Dieulafoy)
Angiodysplasia

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12
Q

What miscellaneous conditions that can be diagnosed / treated through endoscope

A 
Mallory-Weiss tears
Diverticulae 
Foreign bodies 
Stones
Worms
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13
Q

What are the therapeutics of Endoscopy?

A

Ability to treat down the endoscope
GI bleeding
Nerve blocks
Resection of early cancer

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14
Q

What are 3 types of bleeding?

A

Variceal bleeding
Arterial bleeding
Angiodysplasia

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15
Q

Describe haematemesis

A

Vomit which is full of blood

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16
Q

Describe malena

A

Stool with blood with a disgusting smell

17
Q

What is Variceal Bleeding?

A

A medical emergency

18
Q

How do we manage a patient with Variceal Bleeding?

A

ABC resusitate
Injection sclerotherapy
Banding (putting on rubber bands from the endoscope)
Hystocryl glue

19
Q

What is the aim of injecting a sclerosant

A

To cause intesive inflammation in the blood vessel and stop bleeding

20
Q

What is one of the drawbacks of using glue?

A

The scope can end up glued to the surface you are trying to fix. This needs to be changed quickly!

21
Q

How can we treat arterial bleeding?

A 
Injection therapy (adrenaline: tamponade, vasoconstriction)
Heater probe (coagulation
Clips (ligate)
22
Q

How can we treat strictures (narrowing)

A

Dilation (using balloons)
Stenting (usually reserved for malignancy)
Removable stents - can treat perforations with a reduction in long term sequelae. Some are not biodegradable

23
Q

What are the main types of stents

A

Plastic (removable - not often used now)

Metal self expanding (permanent)

24
Q

How does polypectomy work

A

Raise polup on a bed of adrenaline / saline
SNare
Hot biopsy

25
Q

What are polypectomy used for

A

Colonic polyps

26
Q

How does endoscopic mucosal resection (EMR) occur?

A

Raise lesion on a bed of adrenaline / saline
Loop and convert polyp
Snare

27
Q

What can we remove through ERCP

A

Stones and foreign body

28
Q

Describe the removal of a stone

A

Sphincterotomy
Balloon and trawl
Litotripsy

29
Q

How is a foreign body removed?

A

Snare or basket
Overtube
GA with endotracheal tube

30
Q

How does a PEG insertion occur?

A 
Gastroscopy
Identify insertion site 
Transabdominal passage of wire 
Pull wire out of mouth 
Tie PEG tube to wire and pull into position
Fix in place and set up connectors
31
Q

What is the purpose of screening>

A

Prevention of colorectal cancer
Detect polyps and remove them
Early detection of cancer

32
Q

What are the complications of Endoscopy

A 
Respiratory arrest 
Aspiration 
Cardiac Arrest
Bleeding 
Perforation
Infection (bacterial endocarditis)
33
Q

What determines whether a patient is for endoscopy

A

Patients not for endoscopy include:
Indication (justified)
Contraindications (recent infarct)
Bleeding diathesis (including anticoagulant therapy)
Infection risk (prosthetic valves, shunts, immunosuppression)

34
Q

How is a patient prepared for endoscopy?

A 
Indication (clear, justified)
Explaination to patient 
Consent 
Fasting 
Bowel preparation
Monitor bleeding diathesis 
Infection prophylaxis (endocarditis, shunt, immunosuppresion)

Gastro (67 decks)

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