Investigation

Question 1

principles of investigation

Answer 1

• begin with thorough history and examination
• differentiate functional disorders from organic pathology
• start with simple and non-invasive procedures where possible
• justify all investigations requested

Question 2

bedside investigations

Answer 2

BMI
ECG
pulse oximetry
capillary glucose
urinalysis

Question 3

stool analysis: what is involved

Answer 3

• stool culture
• faecal calprotectin
• faecal elastase

Question 4

faecal calprotectin

Answer 4

• raised level in inflammatory conditions

- quantitative analysis useful for monitoring disease activity

Question 5

faecal elastase

Answer 5

• investigation of pancreatic insufficiency/ malabsorption

Question 6

what is involved in GI blood analysis

Answer 6

• urea and electrolytes
• calcium and magnesium
• LFTs (hepatitic, obstructive)
• CRP
• thyroid function
• full blood count
• coagulation
• haematinics

Question 7

what does CRP stand for?

Answer 7

c-reactive protein

Question 8

function of CRP

Answer 8

blood test marker for inflammation in the body

Question 9

what is involved in haematinics blood analysis

Answer 9

• B12
• folate
• ferritin

Question 10

blood analysis hepatic screen details

Answer 10

• hepatits B and C serology
• autoantibodies
• immunoglobulins
• ferritin
• alpha 1 antitrypsin
• caeuloplasmin, copper
• alpha fetoprotein

Question 11

blood analysis coeliac serology details

Answer 11

• tissue transglutaminase
• endomysial antibody
• check IgA levels

Question 12

blood analysis tumour markers details for people with abdominal issues

Answer 12

• CEA not useful as screening test

- may be useful for monitoring response to therapy

Question 13

urine investigations for people with abdominal issues

Answer 13

5HIAA

catecholamines

Question 14

nutritional investigations for people with abdominal issues

Answer 14

trace elements

vitamins

Question 15

importance of laxative screening

Answer 15

for people with weight loss

if you suspect they have been abusing laxatives, can test their blooooooood

Question 16

who da best

Answer 16

you da best

Question 17

what is periwikkleemia?

Answer 17

just kidding - this doesn’t exist mwahahahhahahhah

Question 18

breath testing details

Answer 18

• urea breath test: H Pylori
• hydrogen breath test: bacterial overgrowth
• lactose intolerance

Question 19

oesophageal pH and manometry

Answer 19

• assessment for oesophageal dysmotility

- assess reflux

Question 20

Upper GI endoscopy what happens

Answer 20

• sedation or local anaesthetic
• examines oesophagus to duodenum
• allows biopsy and therapeutic intervention
• oesophageal/ pylori stenting

Question 21

risks of upper GI endoscopy

Answer 21

• perforation
• haemorrhage
• aspiration
• reaction to anaesthetic

Question 22

lower GI colonoscopy

Answer 22

• usually give sedation
• requires bowl preparation
• examine rectum to caecum/ terminal ileum
• allows biopsy/ polypectomy/ EMR

Question 23

polypectomy

Answer 23

remove polyps from inside the colon via colonscopy

Question 24

ERCP

Answer 24

Endoscopic Retrograde Cholangio-Pancreatography)

Question 25

ERCP un-abbrevation

Answer 25

Endoscopic Retrograde Cholangio-Pancreatography)

Question 26

ERCP details

Answer 26

• use sedation or GA
• visualise ampulla, biliary system and pancreatic ducts
• allows biopsy/ cytology, stone removal, stenting, dilation

Question 27

risks of ERCP

Answer 27

pancreatitis

haemorrhage

perforation

infection

mortality

Question 28

function of endoscopic ultrasound

Answer 28

• used for diagnosis and staining

- allows biopsy and cyst drainage

Question 29

enteroscopy function

Answer 29

• visualise small intestine
• double or single balloon enteroscopy
• allows biopsy or therapy for small bowel pathology

Question 30

capsule enteroscopy positive and negative

Answer 30

• less invasive

- no biopsy possible