Endoscopy Lecture Powerpoint

Question 1

60 cm flexible sigmoidscope

Answer 1

Allows for access up to the splenic flexure and sometimes visualizing down the transverse colon with its length, however relatively useless nowadays because more and more polyps are occurring more proximal

Question 2

2 common locations of upper GI bleed

Answer 2

• duodenum

- stomach

Question 3

Recall the ligament of trietz represents the transition from…

Answer 3

…duodenum to jejunum

Question 4

EGD prep (2)

Answer 4

• NPO after midnight
• no anticoagulation (preferred if have to biopsy will bleed)
• local anesthetic spray or sedation (normally sedation is preferred due to how uncomfortable it is)

Question 5

EGD complications (2)

Answer 5

• bleeding

- perforation of often the esophagus

Question 6

Z line

Answer 6

Visible transition point on EGD at the lower esophagus that divides the esophageal tissue above and gastric tissue below, should be clean transition

Question 7

How far from the incisors from the Z line?

Answer 7

35-40cm

Question 8

Schatzki ring

Answer 8

An inflamed ridge where the Z line should be in the lower esophagus

Question 9

Barrett’s esophagus classic description

Answer 9

“salmon colored fingerlike projections into the esophagus past the z line)

Question 10

Fundic gland polyps

Answer 10

A type of benign small non-adenoma that can occur frequently in PPI patients

Question 11

At least __ biopsy samples are required at minimum of a stomach ulcer to ensure it is not cancerous

Answer 11

8

Question 12

Vast majority of stomach is supplied by what vessel?

Answer 12

The celiac trunk

Question 13

What condition is usually not associated with a duodenal ulcer?

Answer 13

Carcinoma of the duodenum

Question 14

Where is the most common part of the duodenum for ulcer disease to occur?

Answer 14

Right after the pyloric sphincter, the duodenal bulb

Question 15

Anterior ulcers of the duodenum vs posterior

Answer 15

Anterior perforate into the peritoneum of the open abdomen, posterior erode the pancreas behind it

Question 16

ERCP common indications (3)

Answer 16

• choledocholithiasis
• pancreatic neoplasm
• bile duct neoplasm

Question 17

How far from the pylorus is the sphincter of oddi?

Answer 17

7cm

Question 18

ERCP and sphincter of oddi dilation are all done under….

Answer 18

….fluoroscopy visualization

Question 19

Endoscopic ultrasound indications (4)

Answer 19

• UGI neoplasm
• choledocholithiasis
• staging
• lymph node biopsy

Question 20

Colonoscopy indications (5)

Answer 20

• anemia
• rectal bleeding without identifiable cause
• abdominal pain
• change in bowel habits (esp alternating diarrhea and constipation)
• screening and followup

Question 21

Colonoscopy prep (4)

Answer 21

• mechanical bowel prep
• clear liquid diet
• NPO after midnight
• no anticoagulation

Question 22

Complications of colonoscopy (3)

Answer 22

• bleeding
• perforation
• splenic injury

Question 23

C diff infection on colonoscopy

Answer 23

Mucus yellow colored pseudomembranes lining the colon

Question 24

Hyperplastic polyp of the colon

Answer 24

Inflammatory polyp of the colon that is very normal and will not become neoplastic and does not need to be removed on colonoscopy

Question 25

Sessile polyp

Answer 25

Flat polyp with a wide base

Question 26

Tubular vs tubulovillous vs villous adenoma

Answer 26

3 types of adenoma that are at increased risk of being cancerous (<5% to 20% to 40%, respectively)

Question 27

Right sided colon lesions ___, while left sided ____

Answer 27

Bleed, obstruct