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PCM III > GI procedures King 12/5 > Flashcards

GI procedures King 12/5 Flashcards

1
Q

indications for NG tube

A

evacuate blood, decompress, remove toxic substances, provide enteral feedings

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2
Q

contraindications NG tube

A

facial trauma, basilar skull fracture, b/l nasal obstruction
recent nasal pharyngeal esophageal or gastric surgery
bleeding diathesis

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3
Q

complications NG tube

A

bleeding aspiration, tracheal intubation, erosion of naris

pharyngeal/nasal perforation

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4
Q

difference of levin tube vs salem sump

A

levin is one lumen with graduated markings on side

salem sump is two lumen so there can be continuous suction without gastric mucosa from being aspirated into lumen

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5
Q

What is EGD

A

endoscope through mouth into duodenum

diagnsotic and therapeutic

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6
Q

Indications for EGD

A

Dx for upper GI disease,
surveillance for cancer
biopsy upper GI disease
therapeutic intervention (control hemorrhage, stenting of stricture, ablation of neoplasms)

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7
Q

absolute contraindications to EGD

A

known or suspected perforation
medically unstable
obstruction

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8
Q

relative contraindications to EGD

A

anticoagulation
pharyngeal diverticulum, recent head or neck surgery
esophageal stricture

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9
Q

complications EGD

A

bleeding, infection, perforation, vocal cord injury, pharyngeal irritation
cardiopulmonary problems

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10
Q

risks for esophagitis

A

alcohol, cigarette smoking, surgery or radiation to chest, medications, prolonged vomiting, weakened imune systems
fungi or virus

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11
Q

what medications can cause esophagitis

A

tetracycline, doxycycline, vit C and aspirin

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12
Q

probable outcome barrets esophagus

A

malignant transformation >50% with 5+ yrs Sx

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13
Q

squamous cell carcinomona more common where in esophagus

adeno?

A

SCC in proximal

adeno in the distal

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14
Q

risk factors with esophageal cancer

A

smoking, ethanol use, high fat. low protein diet, GERD/Barrett’s esophagitis

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15
Q

most common sites metastasis in esophageal cancer

A

lungs, pleura, liver, stomach, peritoneum, kidneys and adrenal gland

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16
Q

what are common causes of gastric ulcers

A

H pylori infection
NSAIDs/aspirin
angular incisura= most common site
then lesser curvature and the antrum

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17
Q

risk factors gastric cancer

A

H pylori, salty and smoked foods
chronic gastritis
smoking, diet low in fruits and vegetables, blood type A

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18
Q

what is a sigmoidoscopy

A

rectum and lower colon examined under direct visualization
60 cm long and 1.25 cm in diameter
inserted through anus

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19
Q

indications sigmoidoscopy

A
  • colorectal cancer screening
  • preoperative evaluation
  • surveillance of preiously diagnosed malignancy in rectum or sigmoid colon
  • local Tx ailments like radiation proctitis
  • removal foreign bodies
  • therapeutic procedures
  • hematochezia requiring hemostasis
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20
Q

absolute contraindications sigmoidoscopy

A 
bowel perforation
acute diverticulitis
active peritonitis
fulminant colitis
cardiopulm instability
21
Q

relative contraindications sigmoidoscopy

A

lack of informed consent
lack of patient cooperation
lack of good bowel preparation

22
Q

complications sigmoidoscop

A

pain
bleeding
perforation
infection

23
Q

why is a colonscopy better than sigmoidoscopy

A

remove polyps in parts of colon beyond sigmoid

other tests like biopsy can be preformed with colonoscope

24
Q

indications colonoscopy

A
  • colorectal cancer screening in average risk adults
  • evaluation and removal of polyps
  • current or previous bowel resection for colon cancer
  • +FMH cancer
  • management of IBD
  • identification acute bleeding sites
  • decompression of colon
25
Q

absolute contraindications colonoscopy

A

fulminant colitis
known or suspected perforation
during early post-colectomy time period

26
Q

relative contraindications colonoscopy

A
  • Hx radiation therapy for abdominal or pelvic cancer
  • Hx abdominal or pelvic malignancy
  • Extensive adhesions from prior abdominal surgery
  • bleeding dyscrasias
  • anticoagulatn therapy
27
Q

-complications colonoscopy

A 
bleeding
perforation
respiratory depression
cardiac arrythmias or ischemia
transient bacteremia
nausea/vomiting
ileus
28
Q

what is a pedunculated polyp

A

mushroom like tissue growths
long thin stalk or peduncule
inherited or non inherited causes

29
Q

what is a sessile polyp

A

no stalk
polyps are flat
generally have more malignant potential

30
Q

colon cancer characteristics

A

partially or completely circumferential and if left unTx will obstruct the lumen

31
Q

UC Sx

A

pain, crmaping, rectal bleeding, diarrhea and fever

32
Q

UC on colonscopy

A

ulceration, bleeding, continuous involvement and pseudopolyps

33
Q

Sx crohns and characteristics

A 
more cramping and diarrhea
less bleeding
(compared to UC)
wax and wane
cobblestone appearance
skips areas of colon
34
Q

What is virtual colonoscopy

A

medical imaging producing 2-3 x dimensional images of colon from rectum to distal ileum
used to Dx colon and bowel including polyps, diverticulosis and cancer

35
Q

How is virtual colonoscopy done

A

XR, CT or MRI

36
Q

Is occult blood test specific

A

no because resin reacts with iron

37
Q

Advantages of fecal occult blood test

A

no cleansing necessary
samples can be collected at home
low cost
does not cause bleeding or tearing/perforation of the lining of the colon

38
Q

disadvantages of fecal occult blood test

A

fails to detech most polyps and some cancers
false positive results are common
dietary restrictions
may need additional procedures if indicates abnormality

39
Q

what are the dietary restrictions needed for fecal occult blood test

A

avoiding meat, certain vegetables, vit C, Fe supplements and aspirin

40
Q

advantages of sigmoidoscopy

A

quick few complications
discomfort is minimal
doc may be able to perform biopsy and remove polyps during test
less extensive cleansing of colon needed than colonoscopy

41
Q

disadvantages of sigmoidoscopy

A

allows doc to view only rectum and lower part of colon
any polyps upper colon will be missed
small risk bleeding, tearing, perforation
may need additional procedures

42
Q

advantages colonscop

A

allows doc to see entire colon

can do other procedures if need be

43
Q

disadvantages colonoscopu

A

need thorough cleansing
does not detect all small polyps, nonpolypoid lesions and cancers
sedation needed
can have bleeding complications

44
Q

advantages of colonography

A

doc can see entire colon

not invasive, little risk

45
Q

disadvantage colonography

A

may not detect all small polyps, nonpolypoid lesions and cancers
thorough cleansing
if polyp or nonpolypoid lesion found have to do biopsy

46
Q

advantages of double contrast barium enema

A

allows doc to see entire colon
complications rare
no sedation necessary

47
Q

disadvantages of double contrast barium enema

A

may not detech small polyps
thorough cleansing is necessary
can have false +
doc cannot perform biopsy or remove polyps during test
additional procedures necessary if test indicates abnormality

48
Q

advantages DRE

A

oftne part of PE
no cleansing needed
quick and painless

49
Q

disadvantages of DRE

A

only detects in lower part of rectum

additional procedures needed if abrnomality

PCM III (17 decks)

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