Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
DU PA GI Sp Studies
Duke PA GI Special Studies
| Question | Answer |
|---|---|
| endoscopy is both __ | diagnostic and therapeutic |
| risks of endoscopy | perforation, bleeding, infection, cardiopulmonary complications secondary to sedation, death |
| upper endoscopy (gastroscope); allows visualization of esophagus, stomach and duodenum | Esophagogastroduodenoscopy (EGD) |
| examines descending colon, sigmoid colon and rectum | flexible sigmoidoscopy |
| visualization of entire colon | colonoscopy |
| push endoscopy of small bowel | enteroscopy |
| combines endoscopy and radiography to image pancreatic and biliary ducts | endoscopic retrograde cholangiopancreatography (ERCP) |
| limited use now. More effective than FOBT less effective than colonoscopy | Flexible sigmoidoscopy |
| diagnostic use of Esophagogastroduodenoscopy (EGD) | dysphagia, odynophagia, refractory GERD, screening for Barret's, PUD, upper GI bleeding, malabsorption |
| therapeutic uses of Esophagogastroduodenoscopy (EGD) | treatment of varices, dilation of strictures, rupture of webs, removal of polyps, stent placement |
| very useful for patients with inflammatory diarrhea who need view of distal colon only | flexible signoidoscopy |
| requires extensive bowel prep and liquid diet for 24 hours prior to procedure. Sedation. indications are CRC screening, evaluation of anemia, bleeding, assessment of IBD | colonoscopy |
| study of choice for CRC (colorectal cancer) | colonoscopy |
| first introduced in 1968 and widely used in diagnosing pancreatic disease. Because of better imaging it is now used mainly for therapy | ERCP |
| ERCP | Endoscopic retrograde cholangiopancreatography |
| initially developed in the 1980s to improve limitations of pancreatic images with trans-abdominal traditional U/S.now regarded as study of choice for staging of rectal, esophageal and gastric tumors and identification of pancreatic tumors | endoscopic ultrasound |
| EUS | endoscopic ultrasound |
| VCE | video capsule endoscopy |
| esophageal indications for VCE | screening for varices, screening for GERD complications, esophagitis |
| small bowel indications for VCE | tumors, obscure bleeding, survey in polyposis syndromes, refractory malabsorption syndromes, |
| has become gold standard visualizing small bowel | VCE |
| avoid VCE in patients with __ | GI distress, fistulas, pregnancy or swallowing disorders |
| low specificity and sensitivity but this is constantly being improved with use of barium, oral and IV contrast, still requires bowel prep, rectal tube | virtual colonoscopy |
| virtual colonoscopy is unable to detect lesions <__ | 5mm |
| what makes up the portal triad | portal vein, hepatic artery, bile duct |
| considered gold standard for evaluation of liver inflammation and or fibrosis | liver biopsy |
| indications for liver biopsy | evaluation of abnormal LFT's, suspected neoplasm, confirmation of diagnosis/prognostication, evaluation of granulomatous disease, unexplained jaundice or suspected drug reaction, to manage post transplantation care |
| contraindications for liver biopsy | increase PT, thrombocytopenia, ascites, difficult body habitus, suspected hemangioma |
| The USTSPF recommends screening for colorectal cancer using __ beginning at age 50 and continuing until age 75. Grade A recommendation | FOBT, sigmoidoscopy, or colonoscopy |
| The USTSPF recommends screening for colorectal cancer using FOBT, sigmoidoscopy, or colonoscopy beginning at age __ and continuing until age 75. | 50 |
| The USTSPF recommends against routine screening for colorectal cancer in patients __ years of age. Grade C recommendation | 76-85 |
| The USTSPF recommends against screening for colorectal cancer in adults older than __. Grade D recommendation | 85 |
| The USPSTF concludes that the evidence is insufficient to assess the benefits and harms of __ and fecal DNA testing as screening modalities for colorectal cancer. Grade I recommendation | computed tomographic colonography |
| this test is part of a routine physical, evaluation for ab pain, and is also a part of routine colorectal cancer screening of asymptomatic individuals older than age 50 | Fecal Occult Blood Test (FOBT) |
| FOBT can detect as little as __ml of blood lost per day | 5 |
| what is the pathology of occult blood in the case of colon cancer | tumors of the intestine grow into the lumen and are subject to repeated trauma by the fecal stream. Eventually the friable tumor ulcerates and bleeding occurs |
| conditions that cause occult blood in the stool | GI tumors, ulcers, IBD, hemorrhoids, swallowed blood (oral or nasopharyngeal bleed), arteriovenous malformations, diverticulosis, and hematobilia |
| __ can create non pathologic occult blood in the stool | vigorous excercise |
| the ingestion of __ can cause false positive for FOBT | red meat and pork(the other white meat), fish, turnips, horseradish |
| a positive result obtained on multiple specimens collected on successive days (four out of six specimens) warrants a __ | thorough GI evaluation |
| drugs that may cause GI bleeding positives with | colchicine, anticoagulants, aspirin, iron preparations, nonsteroidal antiarthritics, and steroids |
| drugs that may cause false negatives include | vitamin C |
| EGD is used to evaluat patients with the following | dysphagia, wt loss, early satiety, upper abdominal pain, ulcer symptoms, dyspepsia, alcoholism and suspected varices, barium swallow suggestive of pathology |
| besides being more sensitive and specific than an upper GI series EGD also can be used __ | therapeutically |
| EGD is contraindicated in patients with __ b/c of risk of perforation | esophageal diverticula |
| examination of the anus and rectum | proctoscopy |
| sigmoidoscopy is diagnostically helpful b/c the lower GI tract is __ | difficult to visualize with radiographs |
| recommended for patients who have had a change in bowel habits or obvious or occult blood in the stool or who ahve abdominal pain. it is also used as a screening tool for those who have had colorectal cancer, inflammatory bowel disease or polyposis | colonoscopy |
| this test is recommended for patients who have had hemoccult positive stools, abnormal sigmoidoscopy, lower GI tract bleeding, or a change in bowel habits. This test is also recommended for those with a high risk of colon cancer | colonoscopy |
| this test is recommended for patients with a strong personal family history of colon cancer, polyps, or ulcerative colitis | colonoscopy |
| the American Cancer Society has proposed a colonoscopy every __ years as an alternative to Hemoccult testing with periodic flexible sigmoidoscopy | 10 |
| colonoscopy is contraindicated in anyone with a recent (14-21 days) __ | colon anastomosis |
| when prepping for colonoscopy it is recommended that the patient drink the entire gallon of glycol preparation within __ hours | 4 |
| __ should indicate immediate cessation of the preparation procedure for colonoscopy | N/V |
| patients with __ should receive prophylactice antibiotics before the test | valvular heart disease |
| Barium enema is indicated in patients with the following conditions. | ab pain, obvious or occult blood in the stools, IBD, suspected cancer (bowel or abdominal, suspected volvus or colon obstruction |
| therapeutically barium enema may be used to __ in children | reduce non-strangulated ileocolic intussusception |
| bleeding from diverticula can cease after a __ | Barium enema |
| ACBE | air contrast barium enema or double contrast barium enema, used especially when small polyps are suspected |
| Barium enema is contraindicated in patients with __ | megacolon |
| colorectal cancer affects __% of men and women | 6 |
| colorectal cancer is fatal in almost __% of cases yet is curable if detected early | 50 |
| the vast majority of colorectal cancers arise from __ that progress over many years to cancer | benign adenomas |
| despite growing awareness of the importance of screening on the part of medical professionals and the public less than __% of patients have undergone screening of any kind | 50 |
| __ are the most important factors in achieving patient compliance with screening programs | discussion and encouragement by primary care provider |
| to detect occult blood the __ has undergone the most extensive testing and has had the greatest clinical use | guaiac-based test (Hemoccult II) |
| to do the guaiac FOBT two slides must be prepared from __ consecutive bowel movements | 3 |
| with guaiac FOBT to avoid false positives patients should abstain from | aspirin, NSAIDS, red meat, poultry, fish, and turnips/horseradish for 72 hours |
| guaiac FOBT slides should be processed within __ days after preparation | 7 |
| __ has a higher sensitivity than Hemoccult II | Hemoccult Sensa |
| patients with positive FOBT should __ | undergo colonoscopy |
| if after a positive FOBT, and a colonoscopy with no identified polyps further screening for colorectal cancer __ | can be deferred for 10 years |
| of those with positive FOBT 5-18% have | colorectal cancer |
| __ are identified in 25-50% of patients with a positive FOBT | adenomatous polyps |
| in several prospective studies __ has been demonstrated to reduce mortality from colorectal cancer by 30-40% among those who are compliant with regular testing | FOBT |
| upon flexible sigmoidoscopy __ are identified in 10-20% of patients | adenomatous polyps |
| upon flexible sigmoidoscopy __ are identified in 1% of patients | colorectal cancers |
| using only flexible sigmoidoscopy means that __% of advanced colonic neoplasia located only in the proximal colon will be overlooked | 30 |
| __ is the preferred screening test in patients deemed to be at higher risk due to a positive family history of colorectal cancer | colonoscopy |
| in asymptomatic individuals 50-75 years old undergoing screening colonoscopy the prevalence of __ is 6-11% | advanced neoplasia |
| in asymptomatic individuals 50-75 years old undergoing screening colonoscopy the prevalence of __ is 1% | cancer |
| the incidence of serious complications after colonoscopy (perforation, bleeding, cariopulmonary events) is __% | 0.1 |
| __ has been widely supplanted by colonoscopy and CT colonography, even though it is widely available, inexpensive and safe | barium enema |
Created by:
bwyche
Popular Medical sets