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FES written exam Questions and Answers 100% Score 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 sligh...

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  • November 11, 2024
  • 16
  • 2024/2025
  • Exam (elaborations)
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FES written exam Questions and Answers

100% Score


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%


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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.




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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

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