FES EXAM STUDY GUIDE QUESTIONS AND ANSWERS LATEST UPDATED 2024
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Course
FES.
Institution
FES.
flexible endoscope viewing manner
front- or side-viewing (oblique) manner
Side viewing scope utility
allow for optimal access to certain areas of the stomach and duodenum and are most commonly utilized during endoscopic retrograde cholangiopancreatography (ERCP)
Video endoscope lighting...
FES EXAM STUDY GUIDE QUESTIONS
AND ANSWERS LATEST UPDATED 2024
flexible endoscope viewing manner
front- or side-viewing (oblique) manner
Side viewing scope utility
allow for optimal access to certain areas of the stomach and duodenum and are most commonly utilized
during endoscopic retrograde cholangiopancreatography (ERCP)
Video endoscope lighting
1. LED at the tip
2. CCD / CMO chip based camera sends digital image back to digital processor
3. Illuination by external source - xenon arc, tungsten filamen lamp or LEDs
2. Suction/biopsy (5-7 o clock position), allow irrigation, suction by depression of suction button.
3. One or more auxiliary channel - for irrigation activated via external foot pump
Cart contents
1. A monitor
2. Video processor
3. Light source with insufflator
4. Water bottle
,5. CO2 source, if available
6. Connection to image management and reporting systems
Umbilical cable use
Umbilical cable connects to the video processing unit either wirelessly or via a separate cable. Full
functionality, including video image, suction, insufflation, and tip deflection, should be tested by the
endoscopist prior to the insertion of the scope.
Common problems encountered for endoscope
1. No, or inadequate, light at end of scope tip
2. Poor image quality
3. No lens washing
4. No insufflation
5. Inadequate suction
6. Unable to pass instrument in channel
7. Altered tip deflection
Insufflation and lens cleaning channel
Room air from the insufflator or CO2 from an external source may be used as an insufflation gas.
Insufflation is achieved by occluding the orifice of the insufflation/lens cleaning button. Depression of
the button provides water to clear the lens.
Suction / biopsy channel
The suction button and biopsy cap share a common channel. Relative to the endoscopic imaging, the
suction/biopsy channel is usually between the 5 and 7 o'clock position.
The channel allows for suction of luminal contents and the passage of endoscopic instrumentation.
Irrigation fluids can also be instilled through the biopsy cap into the intestinal lumen.
,Suction may be activated by depression of the suction button on the handle. Because they share the
same common channel, a device within the biopsy channel may limit the ability to suction.
Endoscopic instruments and endoscope suction channels come in a variety of sizes. The endoscopist
must be aware of the device and channel sizes offered to ensure compatibility.
Anesthesia risk assessment for EGD / C-scope
Medical illnesses and family history
Past medical and surgical history
Allergies
Medications
Previous endoscopies and sedation requirements
Pertinent imaging
Bleeding tendencies
Recommended preprocedural testing for scope
Pregnancy test - prior to endoscopy or fluoroscopy on all females of childbearing age
Coagulation profile - in patients with active bleeding, history of bleeding disorder or any condition
associated with acquired coagulopathy
Chest x-ray - in patients with suspected pulmonary or cardiac decompensationChemistry panel - in
patients with impaired renal, hepatic or endocrine dysfunction
ASA fasting guidelines
Severe constipation bowel prep
more than the usual full bowel preparation, i.e. adding 48 hours of being without oral intake of solids,
adjunctive agents, enemas, more isosmotic preparations and follow clear liquid diet. This condition also
may require full bowel preparation even for limited exams such as sigmoidoscopy.
, elderly bowel prep
should use PEG solutions to avoid electrolyte and fluid shifts.
Hyperosmotic preparation contraindicated in
Renal failure
Acute coronary syndromes
Congestive heart failure
Ileus
Intestinal malabsorption
Ascites
Indications for Abx prophylaxis
1. All patients before initial PEG/PEJ tube placement
2. Before endoscopy of the lower GI tract in patients undergoing continuous ambulatory peritoneal
dialysis
3. All cirrhotic patients with GI bleeding
4. Patients with high-risk cardiac conditions (prosthetic valves, history of infectious endocarditis, cardiac
transplant and congenital heart disease)
5. Prior to ERCP in patients who have had liver transplantation or who have known or suspected biliary
obstruction, where there is a possibility of incomplete biliary drainage
Antithrombotic management
Procedure at high risk for bleeding
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