endoscope

Question 1

technique for using

Answer 1

endoscope controls- left hand

endoscope tip- right arm

Question 2

what are endoscopes used for

Answer 2

diagnosis- both benign and malignant
therapeutics- emergency or elective
screening
surveillance- picking up cancer of the bowel early

Question 3

specialised types of endoscope

Answer 3

gastroscope
colonoscope
side viewing scope
enteroscope
capsule
endoscopic ultrasound

Question 4

visual diagnosis

Answer 4

oesophagitis
gastritis
ulceration
coeliac disease
chrohns disease
ulcerative colitis
sclerosing cholangitis

Question 5

what often causes gastritis

Answer 5

anti-inflammatory tablets

Question 6

treating ulcers

Answer 6

caused by H.Pylori
treated using antibiotics
amoxicillin
clarithromycin or
metronidazole

first line use a PPI- acts on the acid which would aggravate the ulcer already formed

Question 7

miscellaneous conditions identified by endoscope

Answer 7

Mallory-Weiss tears
diverticulae
foreign bodies (food bolus, razor blades)
stones
worms

Question 8

why endoscope good for early diagnosis

Answer 8

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

Question 9

angiodysplasia

Answer 9

growth of new blood cells

so close to the lumen that endoscope can cause bleeding very easy

Question 10

types of bleeding

Answer 10

variceal bleeding
arterial bleeding
angiodysplasia

Question 11

treating variceal bleeding

Answer 11

this is a life threatening medical emergency
ABC resuscitate
injection- fibrinogen
banding
histocryl glue

Question 12

varicose bleeding

Answer 12

very close to the lumen- can be burst through high pressure, food endoscope passing

Question 13

what do we do about varicose bleeding

Answer 13

plastic cap at end of endoscope
stick the cap over the bulge
suction and suck up varic the bleeding bit

bit of string- cutes off blood supply- bleeding point isolated and bleeding stops

Question 14

other treatment for varicose bleeding

Answer 14

sclerosant

glue

Question 15

arterial bleeding

Answer 15

arteries in gut can be eroded into

Question 16

treatment for arterial bleeding

Answer 16

injection therapy
adrenaline
tamponade
vasoconstriction

heater probe - coagulation

clips- ligate
self sealing last about a fortnight then fall off

Question 17

treating angiodysplasia

Answer 17

argon plasma coagulation

recent work with radio frequency ablateion

Question 18

treating strictures

Answer 18

dilation
stenting- usually reserved for malignancy
removable stents

Question 19

complications of a stent

Answer 19

foreign body sensation
reflux
fever
septicaemia
fistula formations
 bleeding
perforation
pain
migration
tumour in/overgrowth

Question 20

tpyes of dilation

Answer 20

balloon

bouginage

Question 21

treating tumours

Answer 21

polypectomy

endoscopic mucosal removal

Question 22

polpypectomy

Answer 22

raise polyp on a bed of adrenaline/saline

snare
hot biopsy

Question 23

endoscopic mucosal resenction

Answer 23

hraise lesion on a bed of adrenaline/saline
loop and conver to polyp
snare

Question 24

how to remove intraluminal objects

Answer 24

stones

foreign body removal

Question 25

foreign body removal

Answer 25

snare or basket overtube GA with endotracheal tube

Question 26

low nutrition treatment

Answer 26

PEG insertion | naso-jejunal tube insertion

Question 27

how to insert PEG

Answer 27

``` gastroscopy identify insertion site transabdominal passage of wire pull wire out of mouth tie PEG to wire and pull into position fix in place and set up connectors ```

Question 28

how to use a naso-jejunal tube

Answer 28

``` pass tube under direct vision pull out endoscope feed in nasal overtube draw NJ tube into overtube withdrawn through nose fix in place ```

Question 29

screening asymptomatic individuals

Answer 29

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

Question 30

what disease are screened for by an endoscope

Answer 30

ulcerative colitis colonic polyps colorectal cancer barrettes oesophagus

Question 31

preparing for endoscope

Answer 31

``` indication- clear and justifies explanation to patient consent fasting bowel prep moniter bleeding diathesis infection prophylaxis (endocarditis, shunt, immunosuppression) ```

Question 32

complications of endoscoope

Answer 32

``` aspiration cardiac arrest bleeding resp arrest perforation infections ```