intro to endoscopy

Question 1

risks of endoscopy (4)

Answer 1

• bleeding
• perforation
• infection
• cardiopulmonary (arrest)

Question 2

two conscious sedatives used in endoscopies

Answer 2

• Fentanyl (narcotic analgesic)
• BZD (retrograde amnesia, midazolam)

Question 3

• to evaluate distal (descending) colon and rectum
• patient gets enema
• non-sedated but patients can request sedation
• 10 mins, cheap, may cause cramping

Answer 3

flexible sigmoidoscopy

Question 4

list 3 conditions flexible sigmoidoscopy can evaluate

Answer 4

• hemorrhoids
• sigmoid diverticulosis
• sigmoid polyps

Question 5

• evaluates large bowel/terminal ileum
• done with conscious sedation
• PEG soln to prep to draw water into colon

Answer 5

colonoscopy

Question 6

colonoscopy clinical indications (6)

NOT conditions

Answer 6

• colon cancer screening, post polypectomy/cancer surveillance
• unexplained Fe anemia
• suspected IBD
• change in bowel habits
• unexplained GI bleeeding
• therapies–polypectomy, FB removal, decompression, hemostasis

Question 7

3 conditions colonoscopy can evaluate

Answer 7

colon polyps
colon cancer
colitis

Question 8

• views UE sphincter to descending duodenum
• often sedated

Answer 8

EGD (upper endoscopy)

Question 9

6 clinical indications for EGD

NOT conditions

Answer 9

• dyspepsia
• persistent reflux
• dysphagia/odynophagia
• persistent N/V w/o etiology
• abdnormal radiograph
• therapy- inc. hemostasis, biopsy, FB removal, dilation, placing feeding tube, metal stent placement

Question 10

6 conditions that EGD can evaluate

Answer 10

• esophagitis
• esophageal cancer
• esophageal varices
• strictures
• hiatal hernia
• ulcer disease

Question 11

treatment of esophageal varices

Answer 11

band ligation
sclerotherapy
octreotide

Question 12

• side viewing scope passed with less visual cues
• requires fluoroscopy

Answer 12

Endoscopic retrograde cholangiopancreatography (ERCP)

Question 13

2 indications for ERCP

Answer 13

• used in removal of common bile duct stones
• tx of jaundice secondary to malignancy

Question 14

unique complication of ERCP

Answer 14

pancreatitis d/t manipulation, contrast, high pressure in pancreatic duct

Question 15

• portable recorder propelled by peristalsis and takes pics every 20 secs
• patient able to do usual activities; dont need to retrieve it
• used in evaluating the small bowel; not steerable
• can’t do biopsy/perform therapies

Answer 15

capsule endoscopy

Question 16

enteroscopy indications (4)

Answer 16

• GI bleeding
• small bowel biopsy
• abnormal xray
• typical findings– angiodysplasia, ulcer, small bowel tumor

Question 17

• inflate two ballons and pull it under general anesthesia in about an hour
• looks at 3/4ths of small bowel
• can also go in from the rectum to look at distal part but less used
• can see entire small bowel; allows for biopsies & therapies

Answer 17

double balloon enteroscope

Question 18

enteroscopic ultrasound (EUS) indications (4)

Answer 18

• stage malignancies of esophagus, rectum, pancreas, stomach
• evaluate pancreas/biliar tree
• submucosal tumor eval
• therapy– FNA biopsy, pseudocyst drainage, celiac plexus block

Question 19

5 risks of EUS

Answer 19

• operator dependent
• risk of perforation
• reproducibility
• accessibility of lesion
• errors in interpretation