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Surgery > GI Bleed/Endoscopy Lecture Powerpoint > Flashcards

GI Bleed/Endoscopy Lecture Powerpoint Flashcards

1
Q

Enteroscopy

A

Viewing of the small intestine with an endoscope inserted down the esophagus

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2
Q

Choledocho- meaning

A

Common bile duct

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3
Q

Indications for Esophageogastroduodenoscopy (EGD) (5)

A
  • unexplained anemia
  • GERD
  • abdominal pain
  • dysphasia
  • barret’s esophagus
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4
Q

EGD prep (3)

A
  • NPO after midnight
  • no anticoagulation
  • optional sedation (propofol)
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5
Q

EGD complications (2)

A
  • bleeding

- perforation

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6
Q

Black eschar lesions at the GE junction indicates

A

Gastritis, often 2nd to NSAID use

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7
Q

ERCP (Endoscopic retrograde choleopancreatography) indications (2)

A
  • obstructed common bile duct (choledocholithiasis, pancreatic neoplasm, bile duct neoplasm)
  • diagnostic and therapeutic
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8
Q

Endoscopic ultrasound indications (4)

A
  • UGI neoplasm (esophagus, stomach, liver, pancreas, duodenum)
  • lymph node biopsy and staging
  • choledocholithiasis
  • small missed cholelithiasis
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9
Q

Colonoscopy indications (5)

A
  • anemia
  • rectal bleeding without identifiable cause
  • diverticulitis
  • alternating diarrhea and constipation
  • screening
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10
Q

Colonoscopy prep (5)

A
  • mechanical bowel prep
  • clear liquid diet
  • NPO after midnight
  • no anticoagulation
  • optional sedation
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11
Q

Colonoscopy complications (3)

A
  • bleeding
  • perforation
  • splenic injury
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12
Q

Types of colonic polyps (4)

A
  • hyperplastic (benign)
  • serrated (same as hyperplastic but higher risk of becoming cancer)
  • inflammatory
  • neoplastic (adenomatous)
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13
Q

Sessile polyp vs pedunculated

A

Sessile is flatter and covers more surface, pedunculated has a stalk protruding out from a base into a large head

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14
Q

Clinical manifestations of adenomatous polyps (4)

A
  • mostly asymptomatic
  • hematochezia
  • occult blood loss
  • diarrhea
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15
Q

How are adenomatous polyps typically detected? (3)

A
  • sigmoidoscopy
  • colonoscopy
  • CT scan (virtual colonscopy)
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16
Q

What type of adenoma polyp is most likely to be cancerous?

A

Villous

17
Q

Dividing area of upper and lower GI

A

Ligament of trietz

18
Q

3 manifestations of GI bleed

A
  • hematemesis
  • melena (black dark tarry stool)
  • hemotochezia (bright red blood)
19
Q

Initial management of GI bleed (3)

A
  • resuscitation (2 large bore IV, saline, type o neg packed RBC, same ratio of plasma and platelets)
  • labs (beware that the H&H will be maintained in acute losses)
  • NG tube
20
Q

Common causes of upper GI bleed (4)

A
  • gastric and duodenal ulcers (most common)
  • varices
  • mallorey weis tears
  • neoplasms
21
Q

Ulcer bleeding treatment options (3)

A
  • PPI or H2 blockers
  • endoscopic hemostasis via injection therapy of 1:10,000 epi
  • coagulation via cauterization
  • surgery (failed or recurrent cases)
22
Q

Anterior wall of the duodenum exits to the ___, posterior wall exits to the ___

A

free abdomen (perforation), pancreas (gastroduodenal artery bleeding, highest risk of rebleeding)

23
Q

Gastric/duodenal ulcer that has a clean base treatment options (2)

A
  • nothing endoscopically

- PPI treatment

24
Q

Varices treatment options (4)

A
  • resuscitation
  • balloon tamponade
  • endoscopic therapy
  • surgical therapy
25
Q

4 categories of surgical varices therapy

A
  • esophageal transection (stapling off varices)
  • nonselective shunting (redirect portal vein flow and put into vena cava - high rates of encephalopathy)
  • selective shunting (adjunctive tube redirecting some flow into vena cava, easy at clotting)
  • orthotopic liver transplantation
26
Q

Transjugular Intrahepatic portosystemic shunt (TIPSS)

A

Lower rates of encehpalopathy and only 50% thrombosis rate at 2 years, making it a great option for patients who will receive a transplant within 2 years, involves putting catheter into internal jugular vein into right atrium and down to vena cava, connect a shunt between the portal and hepatic veins positively effecting varices treatment without changing the vasculature

27
Q

Erosive gastritis treatment options (3)

A
  • self limiting
  • NSAIDS
  • ASA
28
Q

Mallory weiss tear is most often a rip in the ___ mucosa

A

gastric

29
Q

Mallory weiss tear pattern of bleeding

A

-Vomit initially then see bleeding with vomiting

30
Q

Is diverticular bleeding painful?

A

No, most often painless and self resolving but can lead to hypovolemic shock, can be difficult to localize

31
Q

Meckel’s diverticulum

A

An outpouching or bulge in lower part of small intestine (2 feet of the ileocecal valve) often congenital and leftover part of umbilical cord, can see heterotrophic mucosa within the diverticulum, most of the time these are asymptomatic

32
Q

Meckel’s scan

A

A radionucleotide imaging study that can detect the presence of different types of mucosa that will proceed to illuminate where they should be located (for example gastric mucossa in te stomach) and where it shouldn’t be (on the diverticulum

33
Q

Therapy options for lower GI bleed (4)

A
  • colonoscopy
  • surgery (removal of part of colon localizing bleeding)
  • barium enema
  • angiographic embolization (close off vessels to prevent bleeding)

Surgery (27 decks)

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