FES Flashcards
How often should you screen for familial polyposis?
every 1 to 2 years
How often should you screen for Esophageal varices following sclerotherapy and banding
every 6 to 8 weeks
How often should you screen for gastric ulcer
every 6 weeks until healed with biopsy and brushings
How often should you screen for esophageal ulcer
every 6 weeks until healed with biopsy and brushings
How often should you screen for Low risk (short segment, < 3cm, no dysplasia) Barrett’s esophagus?
every 2 years
How often should you screen for high risk (>3cm, circumferenctial) without dysplasia Barrett’s esophagus?
yearly
How often should you screen for high risk Barrett’s esophagus with low grade dysplasia?
Prior to 6 months
How long should a patient be NPO prior to an EGD?
6 to 8 hours
When doing an EGD and there is too much blood, what is a maneuver you can try to empty the fundus of blood and clot?
Roll patient from left side to right side down
You suspect perforation after EGD (cervical crepitus, substernal pain, abdominal pain), what is your next step?
water soluble UGI
What is acceptable INR for EGD
INR 1.5 to 2.5
Patient had first degree relative with colon cancer < age 60. When do they start colonoscopy and how often should they get one?
Start colonoscopy at 40 y/o and get one at least every 5 years
Patient had first degree relative with colon cancer > age 60. When do they start colonoscopy and how often should they get one?
start colonoscopy at 40 y/o and get one at least every 10 years.
Normal patient with no family history of cancer. When do they start colonoscopy and how often should they get one?
Start at 50 and get one at least every 10 years
What is the screening regimen for HNPCC?
Colonoscopy start at age 20 to 25 or 10 years than youngest age of CRCA diagnosis in family. Rpeat every 1 to 2 years
When does HNPCC colon cancers usually develop? How common is it?
up to 20 years earlier than the general population.
6% of all colorectal cancers.
Colorectal cancer found on sigmoidoscopy, next step?
completion colonoscopy
True or False. Occult bleeding should be found by guaiac form a digital rectal exam.
FALSE. Digital rectal exams can cause false positive results thus are not recommended to determine occult bleeding.
Patient with resection for rectal cancer that had a complete colonoscopy prior to surgery. When is their next colonoscopy?
1 to 2 years after their colon resection
Patient with resection for rectal cancer that did not have a complete colonoscopy prior to surgery. When is their next colonoscopy?
3 months after surgery to exclude synchronous lesion
In a colonoscopy, what is the risk of bleeding? perforation?
- bleeding: 1% within 10 days
- perforation: ~0.1%
How do you view a right anterior hemorrhoid via anoscope?
Insert a beveled scope and withdraw the scope to the dentate line
How do you view a left lateral hemorrhoid via anoscope?
re-insert obturator, then re-insert scope into the anal canal and rotate the scope
What is the most common indication for ERCP?
jaundice
Brush biopsy with ERCP has what cancer detection rate?
20 to 60%
Needle aspiration with ERCP has what cancer detection rate?
6 to 30%
Which has a higher rate of post-ERCP pancreatitis - endoscopic sphincterotomy or sphincter balloon dilation?
sphincter balloon dilation
How long do plastic stents in ERCPs remain patent? What happens if you don’t remove them?
3 to 6 months
If you don’t exchange or remove them, they can get clogged and lead to cholangitis
How long can you leave a pancreatic stent in place?
3 weeks; otherwise will lead to ductal damage
When should a patient on warfarin stop their medication prior to ERCP?
5 days prior to the procedure and switched to heparin/lovenox if periprocedural anticoagulation is required.
When should a patient on antiplatelet agent stop their medication prior to ERCP?
10 days prior to the procedure.
restart 5 to 7 days after if sphincterotomy performed
What is the patient’s typical position in ERCP?
prone with head turned towards right shoulder
In ERCP to selectively cannulate the pancreatic duct, what position do you direct your sphincterotome towards?
1 to 3 o’clock position
In ERCP to selectively cannulate the biliary duct, what position do you direct your sphincterotome towards?
11 or 12 o’clock
how common is pancreatitis after an ERCP?
3% to 5%
What size vessels are amenable to coaptive technique for bleeding?
2mm or less
What is the best combination of endoscopic technique to stop bleeding?
Injection with coaptive techniques
what is the most effective way to control bleeding after sphincterotomy?
balloon tamponade
