FES WRITTEN EXAM QUESTIONS | WITH COMPLETE SOLUTIONS.
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
, FES WRITTEN EXAM QUESTIONS | WITH COMPLETE SOLUTIONS.
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 - 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
, FES WRITTEN EXAM QUESTIONS | WITH COMPLETE SOLUTIONS.
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
