Page | 1
FES WRITTEN EXAM
Time frames for upper endoscopy - Familiar polyposis -
ANSWER-1-2 years
Patient positioning for ERCP - ANSWER-prone position with
the head turn toward the right shoulder
patient positioning for upper endoscopy - ANSWER-left side
down, head slightly up.
Maneuver to look at the GE junction - ANSWER-J maneuver
(tip up), rotate the shaft of the scope CCW and withdraw,
pulling the scope into the proximal body and cardia, rotate the
scope 360 around the GE jx,
techniques to decrease post ERCP pancreatitis - ANSWER-
selective bile duct cannulation w/ guidewire, stenting pancreatic
dut w/ stent or guidewire for difficult CBD cannulation, limiting
contrast injection into the pancreatic duct
, Page | 2
Technique for billiary sphincterotomy - ANSWER-apply
pressure w/ cutting wire toward 11 o'clock direction, continue
the sphincterotomy until the intramural portion is cut. Use
blended current with cutting and coag at 15-20J. Alt: can use
balloon dilation but a/w higher rate of post-ECRP pancreatitis
Direction of pancreatic cannulation during ERCP - ANSWER-1
to 3 o'clock position
When to stop warfarin before ERCP - ANSWER-stop 5 days
before and switch to heparin or lovenox if peri-procedural
anticoagulation is required. This can be stopped a day prior to
the procedure
rate of post ERCP pancreatitis - ANSWER-3-5%
Timing of colonoscopy for first degree relative w/ CRC or
adenomas prior to age 60 - ANSWER-colonoscopy at age 40 or
10 years before the youngest affected relative, whichever is
earlier. Then repeat every 5 yrs
, Page | 3
Indications for ECRP - ANSWER-Tissue sampling - bile duct,
pancreatic duct, ampulla bx
chronic pancreatitis/divisum
pancreatic malignancy
billiary malignancy
Benign strictures
Ductal disruption/injury
Jaundice
cholangitis
gallstone pancreatitis
dilated CBD
maneuvers to enter IC valve - ANSWER-rotate the scope until
the valve is at the bottom of the visual field, look down into the
valve, gently insufflate air to open up the valve, OR retroflex the
tip in the cecum and shorten the scope (hook the IV valve)
cancer detection rate of brush biopsy - ANSWER-20-60%
band ligation vs sclerotherapy for esophageal varices -
ANSWER-equal efficacy but baldn ligation has lower
complication rate.
FES WRITTEN EXAM
Time frames for upper endoscopy - Familiar polyposis -
ANSWER-1-2 years
Patient positioning for ERCP - ANSWER-prone position with
the head turn toward the right shoulder
patient positioning for upper endoscopy - ANSWER-left side
down, head slightly up.
Maneuver to look at the GE junction - ANSWER-J maneuver
(tip up), rotate the shaft of the scope CCW and withdraw,
pulling the scope into the proximal body and cardia, rotate the
scope 360 around the GE jx,
techniques to decrease post ERCP pancreatitis - ANSWER-
selective bile duct cannulation w/ guidewire, stenting pancreatic
dut w/ stent or guidewire for difficult CBD cannulation, limiting
contrast injection into the pancreatic duct
, Page | 2
Technique for billiary sphincterotomy - ANSWER-apply
pressure w/ cutting wire toward 11 o'clock direction, continue
the sphincterotomy until the intramural portion is cut. Use
blended current with cutting and coag at 15-20J. Alt: can use
balloon dilation but a/w higher rate of post-ECRP pancreatitis
Direction of pancreatic cannulation during ERCP - ANSWER-1
to 3 o'clock position
When to stop warfarin before ERCP - ANSWER-stop 5 days
before and switch to heparin or lovenox if peri-procedural
anticoagulation is required. This can be stopped a day prior to
the procedure
rate of post ERCP pancreatitis - ANSWER-3-5%
Timing of colonoscopy for first degree relative w/ CRC or
adenomas prior to age 60 - ANSWER-colonoscopy at age 40 or
10 years before the youngest affected relative, whichever is
earlier. Then repeat every 5 yrs
, Page | 3
Indications for ECRP - ANSWER-Tissue sampling - bile duct,
pancreatic duct, ampulla bx
chronic pancreatitis/divisum
pancreatic malignancy
billiary malignancy
Benign strictures
Ductal disruption/injury
Jaundice
cholangitis
gallstone pancreatitis
dilated CBD
maneuvers to enter IC valve - ANSWER-rotate the scope until
the valve is at the bottom of the visual field, look down into the
valve, gently insufflate air to open up the valve, OR retroflex the
tip in the cecum and shorten the scope (hook the IV valve)
cancer detection rate of brush biopsy - ANSWER-20-60%
band ligation vs sclerotherapy for esophageal varices -
ANSWER-equal efficacy but baldn ligation has lower
complication rate.
