FES wri en exam/ FES Exam Ques ons and answers
Newest RATED A+ 100% VERIFIED CORRECT NEW!!
Time frames for upper endoscopy - Familiar polyposis - Ans 1-2 years
Pa ent posi oning for ERCP - Ans prone posi on with the head turn toward the right shoulder
pa ent posi oning for upper endoscopy - Ans le side down, head slightly up.
Maneuver to look at the GE junc on - Ans J maneuver ( p up), rotate the sha 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 pancrea s - Ans selec ve bile duct cannula on w/
guidewire, sten ng pancrea c dut w/ stent or guidewire for difficult CBD cannula on, limi ng
contrast injec on into the pancrea c duct
Technique for billiary sphincterotomy - Ans apply pressure w/ cu6ng wire toward 11 o'clock
direc on, con nue the sphincterotomy un l the intramural por on is cut. Use blended current
with cu6ng and coag at 15-20J. Alt: can use balloon dila on but a/w higher rate of post-ECRP
pancrea s
Direc on of pancrea c cannula on during ERCP - Ans 1 to 3 o'clock posi on
When to stop warfarin before ERCP - Ans stop 5 days before and switch to heparin or lovenox
if peri-procedural an coagula on is required. This can be stopped a day prior to the procedure
rate of post ERCP pancrea s - Ans 3-5%
, Timing of colonoscopy for first degree rela ve w/ CRC or adenomas prior to age 60 - Ans
colonoscopy at age 40 or 10 years before the youngest affected rela ve, whichever is earlier.
Then repeat every 5 yrs
Indica ons for ECRP - Ans Tissue sampling - bile duct, pancrea c duct, ampulla bx
chronic pancrea s/divisum
pancrea c malignancy
billiary malignancy
Benign strictures
Ductal disrup on/injury
Jaundice
cholangi s
gallstone pancrea s
dilated CBD
maneuvers to enter IC valve - Ans rotate the scope un l the valve is at the bo@om of the visual
field, look down into the valve, gently insufflate air to open up the valve, OR retroflex the p in
the cecum and shorten the scope (hook the IV valve)
cancer detec on rate of brush biopsy - Ans 20-60%
band liga on vs sclerotherapy for esophageal varices - Ans equal efficacy but baldn liga on
has lower complica on rate.
cancer detec on rate of needle aspira on - Ans 6-30%
, how long a er sphincterotomy can the bleeding complica on manifest? - Ans immediate up
to 14 days
rela ve contraindica ons for colonoscopy - Ans anal fissure, recent MI, PE, large bowel
obstruc on
Time frames for upper endoscopy - esophageal varices s/p sclerotherapy and banding - Ans
q6-8weeks
Indica ons for screening colonoscopies - Ans over 50 y/o, repeat every 10 years
Time frames for upper endoscopy - pernicious anemia - Ans single endoscopy w/o f/u
complica on rate of diagnos c colonoscopy - Ans 1:1500
Time frames for upper endoscopy - Bare@'s esophagus (high risk) - Ans >3 cm, circumferen al
- yearly
low grade dysplasia - every 6 mo
Factors a/w rebleeding a er endoscopic procedures - Ans endoscopic s gmata w/ ac ve
bleeding and visible vessles having the highest rebleeding risk, pigmenta on 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 ming for pancrea c duct stent - Ans 3 weeks
Defini on of post ECRP pancrea s - Ans increased abdominal pain a/w eleva on of serum
amylase >3x NL
, rela ve contraindica ons for ERCP - Ans cardiopulmonary instability, pregnancy, coagulopathy
screening meline for FAP - Ans lower and upper endoscopy star ng in the early teen years
Time frames for upper endoscopy - Barre@'s esophagus (low risk) - Ans <3cm, no dysplasia,
every 1-2 years
absolute contraindi ons for ERCP - Ans none
maneuver to get to the second por on of the duodenum - Ans dial up and right, with
clockwise torque
what are important variables for achieving hemostasis using coap ve techniques? - Ans probe
size, force of applica on, power se6ng, dura on of energy delivery
How do you confirm that you are in the cecum - Ans visualiza on of appendiceal orifice,
"crow's foot" confluence of taenia, palpate RLQ&transillumina on,
volume of epi injec on - Ans up to 1cc in 0.5-1cc aliquots
max vessel size for effec ve coap ve technique - Ans d=2mm
Why should a supine posi on be avoided in ERCP unless the pa ent cannot turn? - Ans a/w
cannula on difficulty
When is ballon temponde useful? - Ans for controlling bleeding a er endoscopic
sphincterotomy par cularly in se6ngs where a biliary stone extrac on balloon is already in use
Newest RATED A+ 100% VERIFIED CORRECT NEW!!
Time frames for upper endoscopy - Familiar polyposis - Ans 1-2 years
Pa ent posi oning for ERCP - Ans prone posi on with the head turn toward the right shoulder
pa ent posi oning for upper endoscopy - Ans le side down, head slightly up.
Maneuver to look at the GE junc on - Ans J maneuver ( p up), rotate the sha 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 pancrea s - Ans selec ve bile duct cannula on w/
guidewire, sten ng pancrea c dut w/ stent or guidewire for difficult CBD cannula on, limi ng
contrast injec on into the pancrea c duct
Technique for billiary sphincterotomy - Ans apply pressure w/ cu6ng wire toward 11 o'clock
direc on, con nue the sphincterotomy un l the intramural por on is cut. Use blended current
with cu6ng and coag at 15-20J. Alt: can use balloon dila on but a/w higher rate of post-ECRP
pancrea s
Direc on of pancrea c cannula on during ERCP - Ans 1 to 3 o'clock posi on
When to stop warfarin before ERCP - Ans stop 5 days before and switch to heparin or lovenox
if peri-procedural an coagula on is required. This can be stopped a day prior to the procedure
rate of post ERCP pancrea s - Ans 3-5%
, Timing of colonoscopy for first degree rela ve w/ CRC or adenomas prior to age 60 - Ans
colonoscopy at age 40 or 10 years before the youngest affected rela ve, whichever is earlier.
Then repeat every 5 yrs
Indica ons for ECRP - Ans Tissue sampling - bile duct, pancrea c duct, ampulla bx
chronic pancrea s/divisum
pancrea c malignancy
billiary malignancy
Benign strictures
Ductal disrup on/injury
Jaundice
cholangi s
gallstone pancrea s
dilated CBD
maneuvers to enter IC valve - Ans rotate the scope un l the valve is at the bo@om of the visual
field, look down into the valve, gently insufflate air to open up the valve, OR retroflex the p in
the cecum and shorten the scope (hook the IV valve)
cancer detec on rate of brush biopsy - Ans 20-60%
band liga on vs sclerotherapy for esophageal varices - Ans equal efficacy but baldn liga on
has lower complica on rate.
cancer detec on rate of needle aspira on - Ans 6-30%
, how long a er sphincterotomy can the bleeding complica on manifest? - Ans immediate up
to 14 days
rela ve contraindica ons for colonoscopy - Ans anal fissure, recent MI, PE, large bowel
obstruc on
Time frames for upper endoscopy - esophageal varices s/p sclerotherapy and banding - Ans
q6-8weeks
Indica ons for screening colonoscopies - Ans over 50 y/o, repeat every 10 years
Time frames for upper endoscopy - pernicious anemia - Ans single endoscopy w/o f/u
complica on rate of diagnos c colonoscopy - Ans 1:1500
Time frames for upper endoscopy - Bare@'s esophagus (high risk) - Ans >3 cm, circumferen al
- yearly
low grade dysplasia - every 6 mo
Factors a/w rebleeding a er endoscopic procedures - Ans endoscopic s gmata w/ ac ve
bleeding and visible vessles having the highest rebleeding risk, pigmenta on 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 ming for pancrea c duct stent - Ans 3 weeks
Defini on of post ECRP pancrea s - Ans increased abdominal pain a/w eleva on of serum
amylase >3x NL
, rela ve contraindica ons for ERCP - Ans cardiopulmonary instability, pregnancy, coagulopathy
screening meline for FAP - Ans lower and upper endoscopy star ng in the early teen years
Time frames for upper endoscopy - Barre@'s esophagus (low risk) - Ans <3cm, no dysplasia,
every 1-2 years
absolute contraindi ons for ERCP - Ans none
maneuver to get to the second por on of the duodenum - Ans dial up and right, with
clockwise torque
what are important variables for achieving hemostasis using coap ve techniques? - Ans probe
size, force of applica on, power se6ng, dura on of energy delivery
How do you confirm that you are in the cecum - Ans visualiza on of appendiceal orifice,
"crow's foot" confluence of taenia, palpate RLQ&transillumina on,
volume of epi injec on - Ans up to 1cc in 0.5-1cc aliquots
max vessel size for effec ve coap ve technique - Ans d=2mm
Why should a supine posi on be avoided in ERCP unless the pa ent cannot turn? - Ans a/w
cannula on difficulty
When is ballon temponde useful? - Ans for controlling bleeding a er endoscopic
sphincterotomy par cularly in se6ngs where a biliary stone extrac on balloon is already in use
