FES written exam 2026 Actual Questions
and Answers with complete solution
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
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
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.
cancer detection rate of needle aspiration - ANSWER-6-30%
how long after sphincterotomy can the bleeding complication manifest? - ANSWER-
immediate up to 14 days
relative contraindications for colonoscopy - ANSWER-anal fissure, recent MI, PE, large
bowel obstruction
Time frames for upper endoscopy - esophageal varices s/p sclerotherapy and banding -
ANSWER-q6-8weeks
Indications for screening colonoscopies - ANSWER-over 50 y/o, repeat every 10 years
Time frames for upper endoscopy - pernicious anemia - ANSWER-single endoscopy
w/o f/u
complication rate of diagnostic colonoscopy - ANSWER-1:1500
Time frames for upper endoscopy - Barett's esophagus (high risk) - ANSWER->3 cm,
circumferential - yearly
low grade dysplasia - every 6 mo
Factors a/w rebleeding after endoscopic procedures - ANSWER-endoscopic stigmata
w/ active bleeding and visible vessles having the highest rebleeding risk, pigmentation
of a red, dark or white color signifying gradually maturing clots, ulcer size >2cm and
proximity to major arteries, age (>60yo), comorbid status, shock, coagulopathy, anemia
removal timing for pancreatic duct stent - ANSWER-3 weeks
Definition of post ECRP pancreatitis - ANSWER-increased abdominal pain a/w
elevation of serum amylase >3x NL
relative contraindications for ERCP - ANSWER-cardiopulmonary instability, pregnancy,
coagulopathy
and Answers with complete solution
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
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
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.
cancer detection rate of needle aspiration - ANSWER-6-30%
how long after sphincterotomy can the bleeding complication manifest? - ANSWER-
immediate up to 14 days
relative contraindications for colonoscopy - ANSWER-anal fissure, recent MI, PE, large
bowel obstruction
Time frames for upper endoscopy - esophageal varices s/p sclerotherapy and banding -
ANSWER-q6-8weeks
Indications for screening colonoscopies - ANSWER-over 50 y/o, repeat every 10 years
Time frames for upper endoscopy - pernicious anemia - ANSWER-single endoscopy
w/o f/u
complication rate of diagnostic colonoscopy - ANSWER-1:1500
Time frames for upper endoscopy - Barett's esophagus (high risk) - ANSWER->3 cm,
circumferential - yearly
low grade dysplasia - every 6 mo
Factors a/w rebleeding after endoscopic procedures - ANSWER-endoscopic stigmata
w/ active bleeding and visible vessles having the highest rebleeding risk, pigmentation
of a red, dark or white color signifying gradually maturing clots, ulcer size >2cm and
proximity to major arteries, age (>60yo), comorbid status, shock, coagulopathy, anemia
removal timing for pancreatic duct stent - ANSWER-3 weeks
Definition of post ECRP pancreatitis - ANSWER-increased abdominal pain a/w
elevation of serum amylase >3x NL
relative contraindications for ERCP - ANSWER-cardiopulmonary instability, pregnancy,
coagulopathy
