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Systems: Alimentary AB > GI Investigation > Flashcards

GI Investigation Flashcards

1
Q

What are the principles of investigation?

A
  • Begin with thorough history and examination
  • Differentiate functional disorders from organic pathology
  • Start with simple and non-invasive investigation where possible
  • Justify all investigations requested
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2
Q

What bedside investigations are there for GI?

A
  • BMI
  • Pulse oximetry
  • ECG
  • Capillary glucose
  • Urinalysis
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3
Q

What investigations can be carried out as part of stool analysis?

A
  • FOB testing
  • Stool culture
  • Faecal calprotectin
  • Faecal elastase
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4
Q

What is faecal calprotectin used for?

A
  • Raised level in inflammatory conditions

- Quantitative analysis useful for monitoring disease activity

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5
Q

What is faecal elastase used for?

A

Investigation of pancreatic insufficiency/ malabsorption

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6
Q

What investigations are carried out as part of blood analysis?

A
  • U+Es
  • Calcium/ magnesium
  • LFTs
  • CRP
  • Thyroid function
  • FBCs
  • Coagulation
  • Haematinics
  • Hepatitic screen
  • Coeliac serology
  • Tumour markers
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7
Q

What may LFTs show?

A
  • Hepatitic (high ALT, GGT): disorder of the hepatocytes

- Obstructive (high Alk Phos, bilirubin): disorder of bile exiting the liver

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8
Q

What may FBCs show?

A
  • Anaemia: microcytic/macrocytic
  • White cell count e.g IBD
  • Platelet count e.g IBD/neoplasia
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9
Q

What may coagulation tests show you?

A

Hepatic dysfunction

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10
Q

What may haematinics show?

A
  • B12
  • Folate
  • Ferritin
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11
Q

What does a hepatitic screen include?

A
  • Haepatitis B and C serology
  • Autoantibodies (esp ANA, AMA)
  • Immunoglobulins
  • Ferritin
  • Alpha 1 antitrypsin
  • Caeuloplasmin, copper
  • Alpha fetoprotein
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12
Q

What coeliac serology can be carried out?

A
  • Tissue transglutaminase
  • Endomysial antibody
  • Check IgA levels
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13
Q

What may CEA (tumour marker) be useful in?

A

Monitoring response to therapy

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14
Q

What other investigations are there?

A
  • Urine collections (5HIAA, catecholamines)
  • Nutrition screen (trace elements, vitamins)
  • Laxative screen (identify misuse)
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15
Q

What GI physiology investigations are there?

A
  • Breath testing

- Oesophageal pH and manometry

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16
Q

What breath tests are available?

A
  • Urea breath test: H pylori
  • Hydrogen breath test: bacterial overgrowth
  • Lactose intolerance
17
Q

What is oesophageal pH and manometry used for?

A
  • Assessment for oesophageal dysmotility

- Assess reflux

18
Q

What are the risks of upper GI endoscopy?

A
  • Aspiration
  • Perforation
  • Haemorrhage
19
Q

How is upper GI endoscopy carried out?

A

-Under sedation of local anaesthetic

20
Q

What does upper GI endoscopy examine?

A

Oesophagus to the duodenum

21
Q

What can be done during upper GI endoscopy?

A
  • Biopsy
  • Therapeutic intervention
  • Oesophageal/pyliruc stenting
22
Q

How are colonoscopies usually carried out?

A

With sedation

23
Q

What is required before a colonoscopy?

A
  • Bowel preparation e.g picolax

- Renal testing

24
Q

What does a colonoscopy examine?

A

Rectum to caecum/terminal ileum

25
Q

What can be done during colonoscopy?

A
  • Biopsy
  • Polypectomy
  • EMR
26
Q

What are the risks of colonoscopies?

A
  • Perforation
  • Haemorrhage
  • Renal impairment
27
Q

What does ERCP stand for?

A

Endoscopic retrograde cholangio-pancreatography

28
Q

How is ERCP carried out?

A

Under sedation or general anaesthetic

29
Q

What can be seen on ERCP?

A

Visualise ampulla, biliary system and pancreatic ducts

30
Q

What can be done during ERCP?

A
  • Biopsy/cytology
  • Stone removal
  • Stenting
  • Dilatation
31
Q

What are the risks of ERCP?

A
  • Pancreatitis
  • Haemorrhage
  • Perforation
  • Infection
  • Mortality
32
Q

What is endoscopic ultrasound (EUS) used for?

A

Diagnosis and staging

33
Q

What can be done during endoscopic ultrasound?

A
  • Biopsy

- Cyst drainage

34
Q

What can be visualised during enteroscopy?

A

Small intestine

35
Q

What types of enteroscopy are there?

A

Double or single balloon

36
Q

What does enteroscopy allow for?

A

Biopsy or therapy for small bowel pathology

37
Q

What is the downside of capsule enteroscopy?

A

Biopsy is not possible despite being less invasive

Systems: Alimentary AB (37 decks)

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