FES Written Exam Actual Study Guide 2026 - Complete Solutions Updated

FES Written Exam Actual Study Guide 2026 - Complete Solutions Updated 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 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 - pernicious anemia - answer - single endoscopy w/o f/u complication rate of diagnostic colonoscopy - answer - 1:1500 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 - answer - endoscopic 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, coagulopathy, anemia removal timing for pancreatic duct stent - answer - 3 weeks Definition of post ECRP pancreatitis - answer - increased abdominal pain a/w elevation of serum amylase 3x NL relative contraindications for ERCP - answer - cardiopulmonary instability, pregnancy, coagulopathy screening timeline for FAP - answer - lower and upper endoscopy starting in the early teen years Time frames for upper endoscopy - Barrett's esophagus (low risk) - answer - 3cm, no dysplasia, every 1-2 years absolute contrainditions for ERCP - answer - none maneuver to get to the second porti