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GI > the endoscopy and GI tract > Flashcards

the endoscopy and GI tract Flashcards

1
Q

what are 4 parts to a basic endoscope?

A
  • screen
  • light source, air/water
  • control head
  • flexible tip
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2
Q

wha are 6 types of specialised endoscopes?

A
  • gastroscope
  • colonoscope
  • side viewing (ERCP) scope
  • enteroscope (push, double balloon)
  • capsule
  • endoscopic ultrasound
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3
Q

what are 4 uses of endoscopes?

A

1) diagnosis
2) therapeutics
- emergency
- elective
3) screening
4) surveillance

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4
Q

what are 7 diagnosis that can be make by endoscope?

A
  • oesophagitis
  • gastritis
  • ulceration
  • coeliac disease
  • Crohn’s disease
  • ulcerative colitis
  • sclerosis cholangitis
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5
Q

Yes or No.

Can endoscopes identify tumours?

A

= yes

- benign and malignant

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6
Q

what 3 vascular abnormalities can be identified by endoscope?

A
  • varices
  • ecstatic blood vessels’s (GAVE, dieulafoy)
  • angiodysplasia
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7
Q

what are 5 miscellaneous conditions that an endoscope can identify?

A
  • mallory-Weiss tear
  • diverticulae
  • foreign bodies (Bezoars, food bolus, razor blades)
  • stones
  • worms
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8
Q

how is the endoscope used as an early diagnostic tool?

A
  • pre-malignant conditions
  • ability to remove tissue in a minimally invasive way
  • easy to follow up
  • screening
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9
Q

what are newer imaging techniques developed from?

A

= concept of dye staining the oesophagus

- using indigo carmine and iodine

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10
Q

what does chromo-endoscopy looks at use and identify?

A

= uses Lugol’s iodine to identify early squamous carcinoma

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11
Q

describe narrow band imaging?

A

a filter goes in front of light source, only blue and green light is reflected
= blue reflects
= green goes further down
= allowing you to appreciate abnormal blood vessels.

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12
Q

what are 3 microscopic diagnosis that cane be done?

A
  • biopsy & histology
  • brushings & cytology
  • aspirates & biopsies for microbiology
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13
Q

how can an endoscope act a therapeutic agent?

A 
= treats down the endoscope 
- GI bleeding
- nerve blocks
- resection of early cancer 
(limited only by imaging)
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14
Q

what 3 types of bleeding can endoscopes treat?

A
  • variceal bleeding
  • arterial bleeding
  • angio-dysplasia
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15
Q

describe variceal bleeding and how is it treated?

A

= life threatening medical emergency

Treatment;

  • ABC = resuscitate
  • inject fibrinogen (concentrated clotting factor)
  • banding
  • histocryl glue (super glue - obliterates blood vessel & stops bleeding)
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16
Q

what is sclerosant?

A

= used to treat blood vessels or blood vessel abnormalities and also those of the lymphatic system.
- A medicine is injected into the vessels, which makes them shrink.

17
Q

how is arterial bleeding treated?

A

1) infection therapy (adrenaline, tamponade, vasoconstriction)
2) heater probe (coagulation)
3) clips (“ligate”)

18
Q

what is angiodysplasia?

A

= abnormality with blood vessels in GI tract

19
Q

what are 2 ways to treat angiodysplasia?

A

1) argon plasma coagulation

2) recent work with radio frequency ablation

20
Q

what are strictures?

A

= constricting

21
Q

how would you treat strictures?

A

by causing dilation
= Stenting (reserved for malignancy)
- removable stents can treat perforations with a reduction in long term sequlae

22
Q

what are 2 types of stents (oesophageal, biliary, colonic)?

A

1) plastic
= removable

2) metal self expanding (permanent)

23
Q

what are the complications and bleeding risks for metal self expanding stents?

A

Complications

  • foreign body sensations
  • reflux
  • fever
  • septicaemia
  • fistula formation

Bleeding

  • perforation
  • pain
  • migration
  • tumour in/overgrowth
24
Q

what 2 things that can cause dilation?

A

1) balloon

2) bouginage

25
Q

what are 2 ways of removing tumours?

A

1) polypectomy

2) endoscopic mucosal removal

26
Q

what is polypectomy?

A

= raising polyps on a bed of adrenaline/saline

  • snare it then use hot biopsy
  • usually for colonic polyps
27
Q

what is endoscopic mucosal resection?

A

= raise lesions on a bed of adrenaline/saline

  • loop and convert to polyp
  • snare
28
Q

what are 2 objects that could get stuck in the intra-lumen?

A

1) stones (ERCP for removal of them)

2) foreign body removal

29
Q

what are 3 things can you use to remove stones (ERCP)?

A
  • sphincterotomy
  • balloon and trawl
  • lithotripsy
30
Q

what are 3 things can you use to remove foreign body?

A
  • snare or basket
  • overtube
  • GA with endotracheal tube
31
Q

what are 3 ways to help nutrition?

A
  • PEG insertion
  • PEJ
  • nato-jejunal tube insertion
32
Q

describe PEG insertion?

A
  • gastroscopy
  • identify insertion site
  • trans-abdominal passage of wire
  • pull wire out of mouth
  • tie PEG tube to wire and pull into position
  • fix in place and set up connection
33
Q

describe the naso-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
34
Q

why is screening (asymptomatic individuals) used?

A

= to prevent colorectal cancer
= detects polyps and remove them
= early detection of cancer

35
Q

why is surveillance (disease, early detection of complications) used?

A
  • ulcerative colitis (extensive, long standing)
  • colonic polyps and colorectal cancer
  • Barrette’s oesophagus
36
Q

what are 4 considerations to think about when thinking about treatment of certain conditions?

A

1) indication
2) contra-indicatons (recent infarct)
3) bleeding diathesis (anti-coagulant therapy)
4) infection risk (prothetic valves, shunts, immune-suppression)

37
Q

what are 6 complications of possible treatment?

A

1) resp arrest
2) aspiration
3) cardiac arrest
4) bleeding
5) perforation
6) infection(prions, viruses, bacterial endocarditis, immuno-suppression)

GI (43 decks)

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