FES written Exam With Questions And Answers 100% Verified

FES written Exam With Questions And Answers 100% Verified Time frames for upper endoscopy - Familiar polyposis - answer1-2 years Patient positioning for ERCP - answerprone position with the head turn toward the right shoulder patient positioning for upper endoscopy - answerleft side down, head slightly up. Maneuver to look at the GE junction - answerJ 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 - answerselective 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 - answerapply 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 - answer1 to 3 o'clock position When to stop warfarin before ERCP - answerstop 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 - answer3-5% Timing of colonoscopy for first degree relative w/ CRC or adenomas prior to age 60 - answercolonoscopy at age 40 or 10 years before the youngest affected relative, whichever is earlier. Then repeat every 5 yrs Indications for ECRP - answerTissue 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 - answerrotate 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 - answer20-60% band ligation vs sclerotherapy for esophageal varices - answerequal efficacy but baldn ligation has lower complication rate. cancer detection rate of needle aspiration - answer6-30% how long after sphincterotomy can the bleeding complication manifest? - answerimmediate up to 14 days relative contraindications for colonoscopy - answeranal fissure, recent MI, PE, large bowel obstruction Time frames for upper endoscopy - esophageal varices s/p sclerotherapy and banding - answerq6-8weeks Indications for screening colonoscopies - answerover 50 y/o, repeat every 10 years Time frames for upper endoscopy - pernicious anemia - answersingle endoscopy w/o f/u complication rate of diagnostic colonoscopy - answer1:1500 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 - answerendoscopic 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, coagulo