Endoscopy and Surgical Techniques Quiz

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Questions and Answers

What gas is typically introduced into the abdominal cavity during laparoscopic procedures?

  • Nitrous Oxide
  • Helium
  • Oxygen
  • Carbon Dioxide (correct)

Which of the following conditions is NOT typically treated with endoscopy?

  • Stomach ulcer
  • Sinus infection (correct)
  • Chronic constipation
  • Gallstones

What is one of the therapeutic applications of small bowel enteroscopy?

  • Tumor removal
  • Liver biopsy
  • Insertion of SEMS (correct)
  • Appendectomy

Which of the following benefits is associated with using the Da Vinci Surgical System?

<p>Improved control (C)</p> Signup and view all the answers

Which type of endoscopy is specifically indicated for gastroesophageal reflux disease (GERD)?

<p>Upper GI endoscopy (A)</p> Signup and view all the answers

What potential condition can be ruled out by performing a gastroscopy?

<p>Stomach and esophageal cancer (D)</p> Signup and view all the answers

What is a common limitation of endoscopy?

<p>Diagnosis of motility disorders (A)</p> Signup and view all the answers

Which symptom is NOT an indication for small bowel enteroscopy?

<p>Acute headaches (A)</p> Signup and view all the answers

What is one of the main purposes of performing a barium enema?

<p>To evaluate abnormal results (B)</p> Signup and view all the answers

Which of the following is a complication that may arise after a proctoscopy?

<p>Heavy blood loss (C)</p> Signup and view all the answers

What is a common indication for performing a cystoscopy?

<p>Biopsy of a tumor in the bladder (D)</p> Signup and view all the answers

Which condition is a contraindication for cystoscopy?

<p>Active urinary tract infection (C)</p> Signup and view all the answers

What type of cystoscopy is primarily used for easier manipulation during the procedure?

<p>Flexible cystoscopy (D)</p> Signup and view all the answers

What is one of the main uses of gastroscopy?

<p>To diagnose conditions such as ulcers (A)</p> Signup and view all the answers

What does gastroscopy rely on for diagnosis?

<p>Detailed visualization and biopsy (B)</p> Signup and view all the answers

What is a significant risk associated with colonoscopy?

<p>Perforation of the intestine (C)</p> Signup and view all the answers

What condition is NOT a contraindication for colonoscopy?

<p>Influenza symptoms (D)</p> Signup and view all the answers

In what part of the body does a colonoscopy examine?

<p>Entire colon and ileocecum (D)</p> Signup and view all the answers

Which of the following describes the effectiveness of gastroscopy?

<p>It is somewhat unreliable for detecting early-stage cancers. (B)</p> Signup and view all the answers

Which complication is more likely to arise from therapeutic procedures during colonoscopy?

<p>Infection (C)</p> Signup and view all the answers

What should be done when there is uncertainty during colonoscopy?

<p>Pull back the endoscope. (C)</p> Signup and view all the answers

Which of the following segments is NOT typically considered difficult during colonoscopy?

<p>Sigmoid colon (C)</p> Signup and view all the answers

How should patients be positioned prior to intubation for a colonoscopy?

<p>Left lateral decubitus with knees bent. (C)</p> Signup and view all the answers

What is the purpose of performing a digital rectal examination before starting the procedure?

<p>To lubricate the anal canal and relax sphincters. (A)</p> Signup and view all the answers

During colonoscopy, what signifies a red-out sign?

<p>The scope is opposed to the colon mucosa. (B)</p> Signup and view all the answers

What is the incorrect method of managing air during colonoscopy?

<p>Introduce as much air as possible. (C)</p> Signup and view all the answers

Which condition is NOT considered a possible pathology found during colonoscopy?

<p>Halitosis (A)</p> Signup and view all the answers

What technique is used to open the entrance to the terminal ileum during the procedure?

<p>Deflect the tip of the scope. (A)</p> Signup and view all the answers

What is the primary purpose of endoscopy procedures in the small intestine?

<p>To diagnose and treat conditions like bleeding and tumors (C)</p> Signup and view all the answers

Which preparation is recommended before undergoing bronchoscopy?

<p>Fasting for 6-12 hours and avoiding smoking (D)</p> Signup and view all the answers

What complication is associated with bronchoscopy?

<p>Pneumothorax (A)</p> Signup and view all the answers

Which therapeutic indication is NOT associated with gallstones management?

<p>Brachytherapy (D)</p> Signup and view all the answers

What should patients avoid for 24 hours prior to bronchoscopy?

<p>Smoking (C)</p> Signup and view all the answers

What is a contraindication for performing bronchoscopy?

<p>Uncorrectable hypoxemia (D)</p> Signup and view all the answers

What type of endoscopy allows examination of the small intestine beyond the duodenum?

<p>Capsule endoscopy (C)</p> Signup and view all the answers

Which procedure can be performed to relieve endobronchial bleeding?

<p>Stent therapy (B)</p> Signup and view all the answers

What is one of the reasons to suspect that a person's bile may be blocked?

<p>Tumors (B)</p> Signup and view all the answers

What is another name for the pancreatic duct?

<p>Wirsung (B)</p> Signup and view all the answers

Which of the following is a significant risk associated with ERCP?

<p>Excessive bleeding (C)</p> Signup and view all the answers

What is the purpose of proctoscopy?

<p>To detect diseases of the rectum or anus (D)</p> Signup and view all the answers

Before the ERCP procedure, which items should be removed?

<p>Dentures, jewelry, and contact lenses (D)</p> Signup and view all the answers

What generally happens to patients after the ERCP procedure?

<p>They are monitored for 1-2 hours (A)</p> Signup and view all the answers

Which of the following conditions is a contraindication for ERCP?

<p>Existing bowel perforation (C)</p> Signup and view all the answers

What role does local anesthetic play in the ERCP procedure?

<p>Numbs the throat (C)</p> Signup and view all the answers

Flashcards

Gastroscopy (Upper GI Endoscopy)

A procedure that uses a long, flexible tube with a camera attached called an endoscope to view the inside of the digestive system, from the esophagus to the duodenum.

Small Bowel Enteroscopy

A procedure that uses an endoscope to examine the small intestine, specifically the duodenum, jejunum, and ileum.

Colonoscopy

A procedure that uses an endoscope to examine the large intestine, specifically the colon and rectum.

Insufflation

Insertion of gas into the abdomen to inflate it during laparoscopic procedures. This provides space for better visualization and manipulation during the procedure.

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Reflux Esophagitis

A condition characterized by inflammation of the esophagus, often caused by acid reflux.

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Da Vinci Surgical System

A surgical robot system that assists surgeons in performing minimally invasive procedures, such as those involving the stomach and intestines.

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Percutaneous Endoscopic Gastrostomy (PEG)

A surgical procedure that involves placing a tube into the stomach through the abdominal wall. This tube is used to deliver nutrition directly into the stomach.

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Dilation of Strictures

A procedure that involves widening a narrowed passage in the digestive tract using a balloon or stent.

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What is gastroscopy?

A procedure that allows doctors to visualize the upper digestive tract (esophagus, stomach, and duodenum) using a flexible, lighted tube with a camera attached.

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What does gastroscopy help diagnose?

Gastroscopy is a reliable tool for diagnosing conditions in the upper digestive tract like ulcers, inflammation, and cancer. It provides a detailed view of the area allowing for biopsies.

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What is a colonoscopy?

Colonoscopy is a procedure that uses a flexible, lighted tube with a camera to examine the entire colon (large intestine).

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What is the purpose of a colonoscopy?

Colonoscopy is used for diagnosis and preventive care in the colon. It can detect polyps, inflammation, and cancer. It also allows for the removal of polyps to prevent cancer.

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What factors can make colonoscopy difficult?

Colonoscopy can be difficult if the sigmoid colon is mobile or elongated due to anatomical challenges, and post-surgical adhesions can also complicate the procedure.

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How long is a colonoscopy and what skills are required?

Colonoscopy typically takes around 30 minutes to perform. It requires training and skill for proper execution.

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In what cases is colonoscopy contraindicated?

Certain conditions like a perforated intestine, acute diverticulitis, and deep ulceration make Colonoscopy not advised.

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What are the potential risks associated with colonoscopy?

Possible complications of colonoscopy include perforation, bleeding, and infection. The risk of these complications is higher for therapeutic procedures, such as polyp removal.

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Clear View Advance Rule

A critical maneuver that focuses on ensuring a clear view of the colon's interior before advancing the colonoscope. It prevents unnecessary discomfort and potential complications.

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Rectosigmoid Junction

A common area of difficulty during a colonoscopy, often due to its tight curves and narrow passage. It may require careful maneuvering and gentle air inflation.

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Villi

Small, finger-like projections lining the terminal ileum, indicating healthy intestinal function.

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Terminal Ileum (TI)

A specific section of the colon that's easily identified due to its characteristic appearance, often seen on the left side of the colonoscope.

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Diverticulitis

An inflammation of the small pouches in the colon, often causing pain, cramping, and bowel changes.

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Inflammatory Bowel Disease (IBD)

A condition characterized by inflammation of the bowels, manifesting as diarrhea, abdominal pain, and weight loss.

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Enteroscopy

A procedure used to examine deeper parts of the small intestine that cannot be reached by a standard gastroscope.

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What is cystoscopy?

A medical procedure used to examine the inside of the bladder and urethra using a thin, tube-like instrument with a camera. It helps visualize the urinary tract for diagnosis and treatment.

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What is Ureter Renoscopy (URS) or Uretroscopy?

A medical procedure for examining the upper urinary tract, including the renal pelvis and calyx, using a specialized instrument.

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What are the contraindications for cystoscopy?

These are situations where cystoscopy is not recommended due to potential risks or complications.

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What is flexible cystoscopy?

A flexible type of cystoscopy used to access the urinary tract through the urethra.

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What is rigid cystoscopy?

A rigid type of cystoscopy often used in surgical procedures. It offers more control and stability during surgeries.

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Small Bowel Endoscopy

A procedure that uses a long, flexible tube with a camera attached called an endoscope to view the inside of the small intestine.

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Double-Balloon Enteroscopy

A type of small bowel endoscopy that uses a special balloon-assisted endoscope to reach beyond the duodenum.

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Capsule Endoscopy

A capsule-sized endoscope that is swallowed and travels through the digestive system, capturing images of the small intestine.

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Bronchoscopy: Therapeutic Use

The insertion of an endotracheal tube for general anesthesia in patients where extending the neck is dangerous.

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Bronchoscopy

A procedure that uses an endoscope to examine the airways (bronchi) and lungs.

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Pneumothorax

A condition where the air sacs in the lungs collapse, caused by air leaking into the space between the lung and the chest wall.

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Endoscopic Retrograde Cholangiopancreatography (ERCP)

A procedure that uses a flexible endoscope to examine the bile duct system, which carries bile from the gallbladder to the small intestine.

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What is ERCP?

A medical procedure using a flexible, lighted tube with a camera, inserted through the mouth to examine the digestive system from the esophagus to the duodenum.

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Why perform ERCP?

The procedure allows for the identification of narrowing or blockages in the bile or pancreatic ducts caused by tumors, infections, or other abnormalities. It is used to diagnose and treat conditions such as gallstones, pancreatitis, and bile duct cancer.

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How is ERCP performed?

The procedure is performed under IV sedation while the patient is on their back or side. Local anesthetic is sprayed on the back of the throat. An endoscope is inserted through the mouth and guided down the esophagus, into the stomach, and finally into the duodenum where the ampulla of Vater is located.

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What are the potential risks of ERCP?

Common risks include infection, pancreatitis, allergic reactions to sedatives, bleeding, perforation of the GI tract or duct, tissue damage from radiation exposure, and death (rare). The risks can vary depending on the individual patient and the procedure's complexity.

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What happens after ERCP?

After the procedure, the patient is monitored for a couple of hours until the sedatives wear off. They can eat and drink when the throat is no longer numb. If a gallstone was removed or a stent was placed, an overnight stay at the hospital might be necessary.

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When is ERCP not recommended?

Contraindications include unstable cardiovascular or respiratory conditions, unstable neurological issues, psychological problems, existing bowel perforation, abnormal anatomy in the esophagus, stomach, or small intestine, altered surgical anatomy, and coagulopathy for ERCP with sphincterotomy or ampullectomy.

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What is Wirsung?

It refers to the pancreatic duct, also known as the duct of Wirsung. This duct carries digestive enzymes from the pancreas to the duodenum.

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What are some potential complications of ERCP?

Complications can occur in around 1 to 5 percent of cases. The occurrence of complications often depends on the doctor's skill and the patient's underlying health conditions.

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Study Notes

Endoscopy Exam Notes

  • Endoscopy is a procedure used to view and operate on internal organs and vessels of the body.
  • Endoscopy is not only used for the digestive system, but has broader applications.
  • Endoscopy Investigation can be unusual, and it sometimes used to investigate symptoms.
  • Symptoms investigated by Endoscopy can include: vomiting blood, difficulty in swallowing, persistent diarrhoea, persistent abdominal pain, unexplained weight loss, and persistent vomiting.
  • Types of Endoscopy: Laparoscopy (abdomen/pelvis), hysteroscopy (uterus), cystoscopy (bladder), gastroscopy (upper GI), colonoscopy (colon), sigmoidoscopy, endoscopic retrograde cholangiopancreatography (ERCP), bronchoscopy (lungs), laryngoscopy, arthroscopy (joints), nasopharyngoscopy, otoscopy (ear).
  • Advantages of Endoscopy: less invasive than open surgery, allows for descriptive and photographic documentation, low morbidity and mortality.
  • Disadvantages of Endoscopy: only views the surface of the organ, only a small area is visible at a time.
  • Diagnostic and Treatment Uses: Bleeding source, polyps and abnormal tissues.

Capsule Endoscopy

  • Capsule Endoscopy: A capsule with a camera is swallowed to view the digestive tract.
  • Images are transmitted as it passes through.
  • How it Works: Small Video Capsule is used to examine digestive tract & sensors attached to belt around the waist record data.
  • Advantages: Less invasive than open surgery, allows for descriptive and photographic documentation.
  • Disadvantages: Only views the surface of the organ, only a very small area is visible at a time.

Endoscopy A

  • Latest techniques in Endoscopy: Capsule endoscopy, endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound, narrow band imaging.
  • Endoscopic Retrograde Cholangiopancreatography (ERCP): Endoscopy and x-rays combined to treat pancreatic and bile diseases.
  • Endoscopic Ultrasound: High-frequency sound waves to identify digestive and lung disease.
  • Narrow Band Imaging better visualization of internal organs.
  • Chromolendoscopy: Dyes are installed before endoscopy to identify lesions.

Endoscopy B

  • Da Vinci Surgical System: Offers improved dexterity, better control, less risky, and reduced hospital stay for GERD.
  • Types of endoscopy: upper GI endoscopy, enteroscopy, colonoscopy.
  • Endoscopy use: Diagnostic and treatment of inflammatory bowel diseases (Crohn's disease, ulcerative colitis), stomach ulcers, chronic constipation, pancreatitis, gallstones, tumors, and infections.

Endoscopy C

  • Gastroscopy: Provides a reliable way to diagnose ulcers, infections, and cancers, tailored to each patient.
  • Gastroscopy Reliability: Reliable for identifying upper digestive tract abnormalities, but not foolproof for early-stage cancers.
  • Colonscopy: Examines large intestine, looks for abnormalities or pathologies within the mucosal lining.
  • Indications of Colonoscopy: Constipation, abdominal pain, post-polypectomy surveillance, prevention/aftercare for colorectal carcinoma, bleeding per rectum, unexplained anemia, weight loss, pathological thickening of colon wall, and primary tumor search with malignancy.

Endoscopy D

  • Small Bowel Enteroscopy: Used for bleeding in obscure origins.
  • Therapeutic Applications: Foreign body removal, mucosal resection, insertion of self-expandable metal stents, dilation of strictures, ERCP after bariatric surgery.
  • Gastroscopy: Examines upper gastrointestinal tract and first part of the small intestine (duodenum).
  • Usefulness of Gastroscopy: Valuable diagnostic tool allowing doctors to closely examine the upper digestive tract.
  • Techniques: Tissue samples, photography, symptom investigation, ulcer detection, infection, and biopsy for precise diagnoses, and early cancer detection.

Endoscopy E

  • Therapeutic Bronchoscopy: Insertion of an endotracheal tube for general anesthesia, extension of neck.
  • Complications of Bronchoscopy: Pneumothorax, hemorrhage, hypoxemia, bronchospasm in asthmatics, complications of sedation/anaesthesia.
  • Bronchoscopy Treatments: Stent therapy, laser therapy, argon beam coagulation, and brachytherapy, rigid bronchoscopy.
  • Contraindications of Bronchoscopy: Uncorrectable hypoxemia, hypercapnia, and unstable myocardium.

Endoscopy F

  • ERCP (Endoscopic Retrograde Cholangiopancreatography): Examines and treats conditions affecting bile ducts, gallbladder, pancreas, and liver.
  • ERCP Uses: Diagnosing abnormalities and treating problems in the bile ducts, gallbladder, pancreas, and liver.
  • Therapeutic Indications: Sphincterotomy, stone removal, stent placement, balloon dilation, and tissue sampling.

Endoscopy G

  • Cystoscopy: Examine inside of the bladder and urethra using a thin, tube-like instrument.
  • Uses of Cystoscopy: Diagnosis of lesions, follow-up, operative procedures, and treatment of urinary tract infections.
  • Contraindications: Active urinary tract infection, severe urethral stricture, acute prostatitis, severe coagulopathy, recent bladder or ureter disorders, severe cardio respiratory disorders, pregnancy, and a relevant pelvic radiation history.
  • Types of Cystoscopy: Rigid, flexible.

Endoscopy H

  • Proctoscopy: Examines rectum and anal canal using a short, rigid instrument.
  • Proctoscopy Purpose: Detects diseases of the rectum or anus, evaluates abnormal results of barium enemas or bowel tests, monitors rectal bleeding causes and growth of polyps.
  • Proctoscopy Usefulness: Check for rectal cancer, identify abnormalities in the lining of the colon or intestine, identify polyps and other benign growths, and evaluate blood loss, difficulty urinating.
  • Proctoscopy Complications: Heavy blood loss, difficulties urinating, and heavy pain.

Endoscopy I

  • Cystoscopy Indications: Frequent urinary tract infections, blood in the urine (hematuria), and urgent need to urinate with unusual cells. Painful urination, chronic pelvic pain, urinary blockage (prostate enlargement), and abnormal narrowing of the urinary tract.
  • Cystoscopy Indications: Stones in the urinary bladder, unusual growths (polyps, tumors) in the bladder.

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