GI Investigation Flashcards
What investigations should be started with?
Simple
Non-invasive
What five bed-side investigations can be done?
BMI Pulse oximetry ECG Capillary glucose Urinalysis
What types of tests can be done on stool?
FOB testing
Stool culture
Faecal calprotectin
Faecal elastase
What do faecal calprotectins and elastases show?
Calprotectin - Raised level in inflammatory conditions
Elastase - Pancreatic insufficiency/malabsorption
What blood analysis’ should be done? (11)
U&E's Ca/Mg LFTs (Hepatic [High ALT & GGT] & Obstructive (High Alk Phos & Bili [Post-hepatic]) CRP TFTs FBC Coagulatoin Haematinics - B12, Folate & Ferritin Hepatitis screen Coeliac serology Tumour markers
What seven investigations should be done in a hepatitis screen?
Hep B & C serology Autoantibodies – Especially ANA/AMA Immunoglobulins – Outer immune response Ferritin Copper & Caeuroplasmin Alpha-1-antitrypsin AFP
What two other investigations may be done for GI investigations?
Urine collections - CATS (5HIAA)
Nutrition screen - Trace elements and vitamins
What GI Physiology investigations should be done?
Breath testing Oesophageal pH and manometry Upper GI Endoscopy Colonoscopy Endoscopic investigation EUS Enteroscopy Capsule enteroscopy
What are the three risks of Upper GI Endoscopy?
Aspiration
Perforation
Haemorrhage
What are the five risks of endoscopic investigation?
Pancreatitis Haemorrhage Perforation Infection Mortality
What are the three types of breath testing?
Helicobacter - Breaks down Urease
Hydrogen - Shows bacterial overgrowth
Lactose intolerance - Dairy products not broken down causing diarrhoea
What are the three risks of colonoscopy?
Perforation
Haemorrhage (Removing a polyp)
Renal impairment
What imaging modalities are used?
Radiohraphy Contrast studies Ultrasound - FIrst port of call for gall stones CT MRI Nuclear medicine
What is an ERCP good for?
Looking at the biliary tree and pancreatic structures
What is radiography used for?
To confirm the position of the NG tube
