ENDOSCOPY

Question 1

What percentage of people have throat spray (local anaesthetic) during the procedure?

Answer 1

Not more than 60%

Question 2

What is the sedative used for this procedure?

Answer 2

Medazalan (Benzodiazepine)

Question 3

What is the adjunct to medazalan during this procedure?

Answer 3

Fentanyl (opiate)

Question 4

What is the chance of perforating the patients GI?

Answer 4

Less than 0.01

Question 5

What are the indications for a OGD?

Answer 5

Melena
Haemotemesis
Epigastric pain
Dysphasia
Adinaphasia (pain swallowing)
Reflux
Weight loss
Vomiting
Iron deficient anaemia

Question 6

What do you biopsy to diagnose coeliac disease?

Answer 6

Duodenum

Question 7

What could you stent during OGD?

Answer 7

Oesophagus
Pyloric sphincter
Duodenum

Question 8

What can we do for GI bleeds?

Answer 8

Clip bleeding vessels
Corterise
Inject adrenaline

Question 9

How far can you go with a colonoscopy?

Answer 9

Terminal ileum

Question 10

What is bowel preparation?

Answer 10

Taking purgatives such as pikalax which flush out the bowel.

Question 11

Would all patients undergoing endoscopy have sedation?

Answer 11

No but the vast majority would.

Question 12

How long does it take to get to the caecum?

Answer 12

5 mins for a simple patient but can be more like 30-40 mins in a trickier patient.

Question 13

When do you look for the pathology? On the way in or the way out?

Answer 13

The way out. This should take 6 mins minimum.

Question 14

What makes this procedure painful?

Answer 14

Inflating the bowel with air or CO2.

Question 15

What is a sigmoidoscopy?

Answer 15

Endoscopy up to half way up descending colon. No colon flush is required.

Question 16

What side of the colon is thinner and therefore more likely to be perforated?

Answer 16

The right side (ascending colon) is a lot thinner. Can be only 2-3 mm.

Question 17

What are the indications for colonoscopy?

Answer 17

Bright red stool
Persistent constipation
Diarrhoea 
Tenesmus
Screening for colorectal cancer
Removal of polyps

Question 18

What are the treatment possibilities with this procedure?

Answer 18

Haemostasis
Stent
Polypectomy

Question 19

What does OGD stand for?

Answer 19

Oesophageal Gastro Duodenoscopy

Question 20

What does ERCP stand for?

Answer 20

Endoscopic Retrograde Cholangio-Pancreatography

Question 21

What does an ERCP assess?

Answer 21

The biliary tree

Question 22

Does an ERCP put a camera into the ampullae?

Answer 22

No. It inserts a wire into the ampullae, which injects X-ray contrast and take an X-ray to see the biliary tree.

Question 23

Can ERCP be used therapeutically?

Answer 23

ERCP can treat certain problems found during the test. If an abnormal growth is seen, an instrument can be inserted through the endoscope to obtain a sample of the tissue for further testing (biopsy). If a gallstone is present in the common bile duct, the doctor can sometimes remove the stone with instruments inserted through the endoscope. A narrowed bile duct can be opened by inserting a small wire-mesh or plastic tube (called a stent) through the endoscope and into the duct.

Question 24

What does EUS stand for?

Answer 24

Endoscopic Ultrasound

Question 25

What might you use an EUS for?

Answer 25

Biopsy of lesions close to but outside the GI tract and pancreas.