FES

Question 1

How often should you screen for familial polyposis?

Answer 1

every 1 to 2 years

Question 2

How often should you screen for Esophageal varices following sclerotherapy and banding

Answer 2

every 6 to 8 weeks

Question 3

How often should you screen for gastric ulcer

Answer 3

every 6 weeks until healed with biopsy and brushings

Question 4

How often should you screen for esophageal ulcer

Answer 4

every 6 weeks until healed with biopsy and brushings

Question 5

How often should you screen for Low risk (short segment, < 3cm, no dysplasia) Barrett’s esophagus?

Answer 5

every 2 years

Question 6

How often should you screen for high risk (>3cm, circumferenctial) without dysplasia Barrett’s esophagus?

Answer 6

yearly

Question 7

How often should you screen for high risk Barrett’s esophagus with low grade dysplasia?

Answer 7

Prior to 6 months

Question 8

How long should a patient be NPO prior to an EGD?

Answer 8

6 to 8 hours

Question 9

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?

Answer 9

Roll patient from left side to right side down

Question 10

You suspect perforation after EGD (cervical crepitus, substernal pain, abdominal pain), what is your next step?

Answer 10

water soluble UGI

Question 11

What is acceptable INR for EGD

Answer 11

INR 1.5 to 2.5

Question 12

Patient had first degree relative with colon cancer < age 60. When do they start colonoscopy and how often should they get one?

Answer 12

Start colonoscopy at 40 y/o and get one at least every 5 years

Question 13

Patient had first degree relative with colon cancer > age 60. When do they start colonoscopy and how often should they get one?

Answer 13

start colonoscopy at 40 y/o and get one at least every 10 years.

Question 14

Normal patient with no family history of cancer. When do they start colonoscopy and how often should they get one?

Answer 14

Start at 50 and get one at least every 10 years

Question 15

What is the screening regimen for HNPCC?

Answer 15

Colonoscopy start at age 20 to 25 or 10 years than youngest age of CRCA diagnosis in family. Rpeat every 1 to 2 years

Question 16

When does HNPCC colon cancers usually develop? How common is it?

Answer 16

up to 20 years earlier than the general population.

6% of all colorectal cancers.

Question 17

Colorectal cancer found on sigmoidoscopy, next step?

Answer 17

completion colonoscopy

Question 18

True or False. Occult bleeding should be found by guaiac form a digital rectal exam.

Answer 18

FALSE. Digital rectal exams can cause false positive results thus are not recommended to determine occult bleeding.

Question 19

Patient with resection for rectal cancer that had a complete colonoscopy prior to surgery. When is their next colonoscopy?

Answer 19

1 to 2 years after their colon resection

Question 20

Patient with resection for rectal cancer that did not have a complete colonoscopy prior to surgery. When is their next colonoscopy?

Answer 20

3 months after surgery to exclude synchronous lesion

Question 21

In a colonoscopy, what is the risk of bleeding? perforation?

Answer 21

• bleeding: 1% within 10 days

- perforation: ~0.1%

Question 22

How do you view a right anterior hemorrhoid via anoscope?

Answer 22

Insert a beveled scope and withdraw the scope to the dentate line

Question 23

How do you view a left lateral hemorrhoid via anoscope?

Answer 23

re-insert obturator, then re-insert scope into the anal canal and rotate the scope

Question 24

What is the most common indication for ERCP?

Answer 24

jaundice

Question 25

Brush biopsy with ERCP has what cancer detection rate?

Answer 25

20 to 60%

Question 26

Needle aspiration with ERCP has what cancer detection rate?

Answer 26

6 to 30%

Question 27

Which has a higher rate of post-ERCP pancreatitis - endoscopic sphincterotomy or sphincter balloon dilation?

Answer 27

sphincter balloon dilation

Question 28

How long do plastic stents in ERCPs remain patent? What happens if you don’t remove them?

Answer 28

3 to 6 months

If you don’t exchange or remove them, they can get clogged and lead to cholangitis

Question 29

How long can you leave a pancreatic stent in place?

Answer 29

3 weeks; otherwise will lead to ductal damage

Question 30

When should a patient on warfarin stop their medication prior to ERCP?

Answer 30

5 days prior to the procedure and switched to heparin/lovenox if periprocedural anticoagulation is required.

Question 31

When should a patient on antiplatelet agent stop their medication prior to ERCP?

Answer 31

10 days prior to the procedure.

restart 5 to 7 days after if sphincterotomy performed

Question 32

What is the patient’s typical position in ERCP?

Answer 32

prone with head turned towards right shoulder

Question 33

In ERCP to selectively cannulate the pancreatic duct, what position do you direct your sphincterotome towards?

Answer 33

1 to 3 o’clock position

Question 34

In ERCP to selectively cannulate the biliary duct, what position do you direct your sphincterotome towards?

Answer 34

11 or 12 o’clock

Question 35

how common is pancreatitis after an ERCP?

Answer 35

3% to 5%

Question 36

What size vessels are amenable to coaptive technique for bleeding?

Answer 36

2mm or less

Question 37

What is the best combination of endoscopic technique to stop bleeding?

Answer 37

Injection with coaptive techniques

Question 38

what is the most effective way to control bleeding after sphincterotomy?

Answer 38

balloon tamponade