Endoscopy Flashcards
What are the 6 specialised types of endoscope?
Gastroscope, colonoscope, side viewing (ERCP) scope, enteroscope (bit inbetween small bowel), capsule, endoscopic ultrasound.
How can video be viewed from a capsule?
Electrodes are stuck onto chest which allows beaming of video so it can be viewed.
What does an EUS (ultrasound) scope allow?
Sampling of organs.
What conditions can endoscopy give a visual diagnosis of?
Oesophagitis, gastritis, ulceration, coeliac disease, Crohn’s disease, ulcerative colitis, sclerosing cholangitis.
What are the 3 types of vascular abnormalities that an endocope can see?
Varices (enlarged veins), ectatic blood vessels (vessels grow on mucosal surface), angiodysplasia (small vascular abnormalities).
What are the downsides of staining the oesophagus with indigo carmine and iodine?
It is messy, time consuming, patchy, and iodine is sore.
What is narrow band imaging?
Where the frequencies of light that is used is changed.
What are the 3 types of samples that endoscopes can take from the body?
- Biopsy (for histology).
- Brushings (for cyotology).
- Aspirates and biospies (for microbiology, rarely).
What are the 3 main treatments that can be given by an endoscope?
GI bleeding, nerve blocks and resection of early cancer.
What are the 3 GI bleeds that can be fixed by endoscopy?
Variceal bleeding, arterial bleeding (can be done to ulcers), angiodysplagia.
What is vomiting and defecating blood called?
Vomiting - haematemesis. Defecating - melaena.
What are the 3 ways an endoscope can treat variceal bleeding?
Injecting fibrinogen, banding and histocryl glue.
Describe the process of banding.
Band is put on end of endoscope, endoscope sucks up varix, band is flicked off endoscope, leads to sealed off varix.
What is sclerosant?
An injectable irritant used to treat varices by producing thrombi in them.
What are the 3 ways an endoscope can treat arterial bleeding?
Injection therapy (adrenaline), heater probe, clips (ligate).
What are the 2 ways angiodysplasia can be treated by an endoscope?
Argon plasma coagulation, recent work with radio frequency ablation.
What is the possible endoscopic treatment for strictures?
Stenting.
What are the possible complications of stenting?
Foreign body sensation, reflux, fever, septicaemia, fistula formation, bleeding, perforation, pain, migration, tumour in/overgrowth.
What are the 2 ways that endoscopy can be used to treat tumours?
Polypectomy, endoscopic mucosal removal.
How would an endoscopic mucosal resection be done?
Raise lesion on a bed of adrenaline and saline, loop and convert to polyp, snare.
How would you remove stones from the bile duct?
Sphincterotomy, balloon and pull out stones.
Lithotripsy (use of high energy waves to break down stones).
What tubes can be inserted using an endoscope to provide nutrition?
PEG, PEJ, naso-jejunal tube.
How would you do a PEG insertion?
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.
How you you insert a naso-jejunal tube?
Pass tube under direct vision, pull out endoscope, feed in nasal overtube, draw NJ tube into overtube, withdraw through nose, fix in place.
What diseases need endoscopic surveillance to detect complications early?
Ulcerative colitis (extensive, long standing), colonic polyps and colorectal cancer, Barret’s oesophagus.
Give an example of a contraindication for endoscopy.
Recent MI.
What does bleeding diathesis mean and can you do an endoscopy if one is present?
Susceptibility to bleeding e.g. anticoagulant therapy. No.
What kinds of things put you at risk of infection from endoscopy?
Prosthetic valves, shunts, immunosuppression.
What kind of preaparations need to be done before an endoscopy/colonoscopy?
Explanation to patient, consent, fasting, bowel prep, monitor bleeding diathesis, infection prophylaxis.
What are the potential complications of endoscopy?
Respiratory arrest, aspiration, cardiac arrest, bleeding, perforation, infection.
What is the GMC guidance on obtaining consent to carry out an endoscopy?
Work in partnership with patients, respect patients view, discuss what treatment involves, share info to make decisions, allow to make decisions, respect those decisions.
