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Flashcards in Endoscopy Deck (19)
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1
Q

Name the two types of endoscope and how they can be used

A

Rigid-arthroscopy

flexible- GI narrow diameter four way tip deflection

2
Q

What is the role of endoscopy therapeutic and diagnostic

A
Observation 
FNA 
Fluid sampling 
Biopsy 
Brush cytology 
Feeding tube 
FB removal 
Stricture dilation
3
Q

Contra indications of endoscopy

A
Cardiac arrhythmia unable to be anaesthetised 
Hypoxaemia 
Uncorrected bleeding disorder
Shock
Bowel perforation 
Hypoproteinaemia 
Inadequate previous investigations
Inadequate preparation
4
Q

Limitations of the endoscope

A
Intra peritoneal lesions
Sub-mucosal lesions 
cannot observe the entire GI tract 
Enzyme deficiencies 
Assessment of morphological not functional disorders
5
Q

Complications endoscopy

A

Acute bradycardia-Vagal nerve stimulated on entered into the small intestine (correct atropine)
Decreased venous return( over distension of the stomach, compression vena cava, drop venous return and blood pressure, decreased tidal volume, drop in blood pressure, increased antro-pyloric contractility)
Bacteraemia- Transient bacteraemia, use intra-op antibiotics for patients at risk, GI bleed, valvular heart disease
Haemorrhage- usually associated with malignency
GI perforation- forceful insertion, poor biopsy technique, insuffination enough to rupture ulcerated area
Transmission of infection
Laceration of major vessels or
adjacent organs
o FB removal (fish hook)
o stricture dilatation

6
Q

List the major components of the endoscope system

A
Light source (xenon) 
Suction/insufflation: water reservoir 
Flexible endoscope
7
Q

Discuss the advantages and disadvantages of the two types of endoscope

A

Fibre optic
Portable, Cheap , Wide range of sizes
But
Fragile, loose image when broken, difficult to rotate, lower diameter lower resolution, required CCD(charged couple device) camera
Video
High quality image, flexible, video capability, image visible to assistant, better resolution
But
Expensive, not portable, very small diameter not available

8
Q

Ideal endoscope characteristics

A

Tip, large enough diameter for good accessory channel
Length- 1 meter humans 1.5 giant breeds difficult to control
Viewing angle- panoramic examination 90-120 degrees
Steering- 180 degrees, four way tip deflection
Biopsy forceps-oval cups, fenestrations, swing jaws

9
Q

Patient preparation for GI endoscopy (barium) and colon Dog

A

Full physical exam, lab tests, faecal exam out rule systemic disease
Gastric scope-withhold food for 12 hrs, if not danger aspiration vomiting, clogging scope, poor visualisation. If had barium delay for 24 hours and dilute it
Colon scope-withhold food 36 hours. Lavage-isosmotic solutions, kleanprep, 2-4 doses 25/30ml/kg at least two hours apart, last dose 12 hours before scope. Enema-one Litre of warm water. Lube tube insert to level of the last rib, move tube backwards and forwards as water is added. Repeated until liquid runs clear

10
Q

Prep for endoscope cat

A

PEG / electrolyte solution
• 20 ml/kg by N/G tube infusion over four hours
• 20 ml/kg warm water enema through urinary catheter

11
Q

Ga endoscope patient positioning and monitoring

A

Be aware risk aspiration keep ET tube inflated.
Reduced venous return blood pressure and tidal volume (over extension stomach)
Always insert a mouth gag
Do not use nitrous
Left lateral recumbency
ECG Iv access blood pressure

12
Q

What are the advanced uses for endoscopy?

A
Advanced
• enteroscopy
• fluorescence
• ultrasound
• ERCP
• GFST
• confocal
 polypectomy
• electro and laser surgery
• plication
13
Q

What are the advantages of using endoscopy?

A

it is ‘minimally invasive’
• morbidity and mortality is low
• there is no convalescence

14
Q

What considerations must be made for endoscopy?

A

there is a small but significant risk

• it is not always the best approach

15
Q

Which patients are unfit for endoscopy use?

A
Absolute
• unfit for anaesthesia
o uncorrected bleeding disorder
o non-reversible hypoxaemia
o unstable cardiac arrhythmias
o cardiac failure
• bowel perforation
• poor cardiopulmonary reserve
• uraemia
• hypoproteinaemia
o still relative anaesthetic risk
o full-thickness biopsies may be needed ?
• inadequate investigation
• inadequate preparation
16
Q

List the endoscopic accessories that can be used?

A
biopsy forceps
• cytology brushes
• wash & collection tubes
• injection / aspiration
needles
17
Q

List the preliminary examination techniques before endoscopy is used?

A
preliminary investigations
o history
o physical examination
o faecal examination
o minimum data base
o plain radiographs
o ± contrast radiographs
o ultrasound
18
Q

What disinfectants are used to clean the endoscope and what must you never do?

A

ethylene oxide gas sterilisation
• approved disinfectant
Use of the autoclave

19
Q

What GI disorders can the endoscope assess?

A

Motility disorders
Brush border cytology
HYPERSECRETORY DISORDERS