the endoscope and the GI tract Flashcards

1
Q

what are the 4 parts of the basic endoscope?

A

screen
light source, air water
control head
flexible tip

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2
Q

name 6 types of specialised endoscope

A
gastroscope (stomach)
colonoscope (colon)
side viewing (ERCP) scope (liver/biliary tree)
enteroscope (push, double balloon)
Capsule
Endoscopic ultrasound
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3
Q

list 4 uses of endoscopes

A

diagnosis
therapy (emergency and elective)
screening
surveillance

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4
Q

what visual disgnoses can be made via endoscopy?

A
oesophagitis
gastritis
ulceration
coeliac disease
crohns disease
ulcerative colitis
sclerosing cholangitis
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5
Q

what is contained within the endoscope?

A

camera
tube to suck up blood etc
light

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6
Q

how do capsules work?

A
swallowed
has battery (so must pass through, cant get stuck or will cause damage), light and camera which produces video of GI tract as it passes through
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7
Q

what does EUS scope do?

A

press up against wall
produces image of organs etc via altrasound
can take samples via needle

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8
Q

describe the endoscopy technique

A

endoscope tip inserted

direction of the endoscope operated with left hand by endoscope controls

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9
Q

what type of vascular abnormalities can be discovered by endoscopy?

A

varices
ectatic blood vessels (GAVE, dieulafoy)
angiodysplasia

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10
Q

name some miscellaneous conditions that can be picked up on by endoscopy

A
Mallory-Weiss tears
diverticulae
foreign bodies (bezoars, food, razor blades etc)
stones
worms
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11
Q

what are the benefits of early diagnosis?

A

can pick up pre-malignant conditions
can remove tissue in minimally invasive way
easy to follow up
screening

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12
Q

what is barrets cancer?

A

.

small initial lesion can be removed if caught early

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13
Q

what is lugals iodine used for?

A

squirted onto oesophagus, makes abnormal mucosa more obvious

chromoendoscopy

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14
Q

what is narrow band imaging?

A

uses different lights to illuminate deeper tissue

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15
Q

how are diagnoses made via microscopy?

A

biopsy and histology
brushings and cytology
rarely, aspirates and biopsies for microbiology

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16
Q

what is a therapeutic endoscopy?

A

endoscopy with the ability to treat down the endoscope

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17
Q

what 3 types of bleeding can occur in the GI tract?

A

variceal bleeding
arterial bleeding
angiodysplasia

18
Q

what clinical observations indicate GI bleeding?

A

haematemesis (vomiting dark, bloody, thick sunstance)

Malaena (dark brown, bloddy, thick, feaces)

19
Q

How is variceal bleeding treated?

A
medical emergency
Banding
injection fibrinogen
histocryl glue
ABC, resuscitate
20
Q

how is arterial bleeding treated?

A
injection therapy (adrenaline: tamponade, vasoconstriction)
heater probe (coagulation)
Clips (ligate)
21
Q

what is angiodysplasia and how is it treated?

A

small vascular malformation of the gut
treated with:
- argon plasma coagulation
radio frequency ablation

22
Q

how are strictures treated?

A

stenting (usually in malignancy)

23
Q

what are the 2 types of stent and where are they used?

A

used in oesophagus, biliary tree, colon
Plastic (removable)
Metal self expanding (permanent)

24
Q

what are the possible complications of a stent?

A
reflux
fever
septicaemia
fistulae
foreign body sensation
bleeding
25
Q

name 2 methods of dilatation

A

balloon

bouginage

26
Q

.

A

.

27
Q

via what 2 methods can early stage tumours be removed?

A

polypectomy

endoscopic mucosal removal

28
Q

what is a polypectomy?

A

removal of polyp before it turns cancerous
1)raise polyp on a bed of adrenaline/saline
2)snare
3)hot biopsy
Usually for colonic polyps

29
Q

what is an endoscopic mucosal removal?

A

removal of early stage cancer/precancerous growths

1) raise lesion on bed of adrenaline/saline
2) loop and convert to poly
3) snare

30
Q

give 2 examples of intraluminal objects that would need to be removed

A

stones (ERCP)

foreign bodies

31
Q

.via what 3 methods can stones be removed?

A

.sphincterotomy
balloon and trawl
lithotripsy

32
Q

name 3 methods of foreign body removal

A

snare or basket
overtube
GA with endotracheal tube

33
Q

how are endoscopes used in nutrition?

A

PEG insertion
PEJ
naso-jejunal tube insertion

34
Q

what is PEG insertion?

A
gastroscopy
transabdominal passage of wire
pull wire out of mouth
Tie PEG tube to wire and pull into position
Fix in place and set up connectors
35
Q

What is anaso-jejunal tube?

A
pass tube under direct vision
pull out endoscope
feed in nasal overtube
draw NJ tube into overtube
withdraw through nose
fix in place
36
Q

what are the aims of screening?

A

prevention of colorectal cancer
detect polyps and remove them
early detection of cancer

37
Q

what things is surveillance used for?

A

ulcerative colitis (IBD)
colonic polyps and colorectal cancer
Barrets oesophagus

38
Q

how are patients selected for endoscopy?

A

indications
contraindications (recent infarct)
bleeding diathesis (eg. anticoagulants)
infection risk (prosthetic valves)

39
Q

how must a patient be prepared for endoscopy?

A
clear indication
explanation to patient
consent
fasting
bowel preparation (emptying)
monitor bleeding diathesis
infection prophylaxis
40
Q

what complications can arise from endoscopy?

A
resp arrest
aspiration
cardiac arrest
bleeding
perforation
infection