Flashcards in Endoscope and the GI tract Deck (34):
1
What are the parts of a basic endoscope
Screen, Light source, air/ water, control head and flexible tip
2
What are some specialised types of endoscope and what do they look at?
Gastroscope - Stomach
Colonoscope - Colon
Side viewing ERCP - Some of the organs that come off of the GI tract
Enteroscope - looking at the bit you cant see with the Gastroscope (Small bowel)
Capsule - pill cam
Endoscopic Ultrasound - lumen of the stomach - can scan the organs from inside out
3
How big are capsule?
1-2cm
4
What are the risks with capsule?
They contain a battery which must come out
Difficult to swallow
Relatively expensive
5
What are the drawbacks of the EUS Scopes
Very expensive
6
What do patients need before an endoscope
Sedative or anaesthetic
7
What are endoscopes used for?
Diagnostics - cancer, inflammation and ulcers
Therapeutics - Biopsy abnormalities
Treat things - to stop a bleeding ulcer
Screening - early diagnoses of cancers - Colorectal cancer screening. taking a healthy population to try and pick up pre-malignant cells and cure them
Surveillance - people with an illness that we want to keep an eye on.
8
What is Barrett's oesophagus
a metaplasia caused by a chemical irritation
cells undergo a metaplastic change to thick, cuboidal cells so that it is more like the stomach, so not as badly effected by acid reflux
9
What can be diagnosed through visual diagnoses?
Oesophagitis
Gastritis
Ulceration
Coeliac disease
Crohn's dsease
Ulcerative colitis
Sclerosing cholangitis
10
What are the two different types of tumours
Malignant and Benign tumours
11
What are some vascular abornalities
Varices
Ectatic blood vessels (GAVE, Dieulafoy)
Angiodysplasia
12
What miscellaneous conditions that can be diagnosed / treated through endoscope
Mallory-Weiss tears
Diverticulae
Foreign bodies
Stones
Worms
13
What are the therapeutics of Endoscopy?
Ability to treat down the endoscope
GI bleeding
Nerve blocks
Resection of early cancer
14
What are 3 types of bleeding?
Variceal bleeding
Arterial bleeding
Angiodysplasia
15
Describe haematemesis
Vomit which is full of blood
16
Describe malena
Stool with blood with a disgusting smell
17
What is Variceal Bleeding?
A medical emergency
18
How do we manage a patient with Variceal Bleeding?
ABC resusitate
Injection sclerotherapy
Banding (putting on rubber bands from the endoscope)
Hystocryl glue
19
What is the aim of injecting a sclerosant
To cause intesive inflammation in the blood vessel and stop bleeding
20
What is one of the drawbacks of using glue?
The scope can end up glued to the surface you are trying to fix. This needs to be changed quickly!
21
How can we treat arterial bleeding?
Injection therapy (adrenaline: tamponade, vasoconstriction)
Heater probe (coagulation
Clips (ligate)
22
How can we treat strictures (narrowing)
Dilation (using balloons)
Stenting (usually reserved for malignancy)
Removable stents - can treat perforations with a reduction in long term sequelae. Some are not biodegradable
23
What are the main types of stents
Plastic (removable - not often used now)
Metal self expanding (permanent)
24
How does polypectomy work
Raise polup on a bed of adrenaline / saline
SNare
Hot biopsy
25
What are polypectomy used for
Colonic polyps
26
How does endoscopic mucosal resection (EMR) occur?
Raise lesion on a bed of adrenaline / saline
Loop and convert polyp
Snare
27
What can we remove through ERCP
Stones and foreign body
28
Describe the removal of a stone
Sphincterotomy
Balloon and trawl
Litotripsy
29
How is a foreign body removed?
Snare or basket
Overtube
GA with endotracheal tube
30
How does a PEG insertion occur?
Gastroscopy
Identify insertion site
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
31
What is the purpose of screening>
Prevention of colorectal cancer
Detect polyps and remove them
Early detection of cancer
32
What are the complications of Endoscopy
Respiratory arrest
Aspiration
Cardiac Arrest
Bleeding
Perforation
Infection (bacterial endocarditis)
33
What determines whether a patient is for endoscopy
Patients not for endoscopy include:
Indication (justified)
Contraindications (recent infarct)
Bleeding diathesis (including anticoagulant therapy)
Infection risk (prosthetic valves, shunts, immunosuppression)
34