ABPS GI Endoscopy flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Split-dose bowel preparation

Regimen dividing the total polyethylene glycol solution into two doses, with the second taken 4-6 hours before colonoscopy, improving cleansing and patient tolerability.

Boston Bowel Preparation Scale

Validated 0-3 scoring of each colon segment after washing, summed to a total of 0-9, with 2 or more per segment indicating adequate preparation.

ASA physical status

Classification of patient comorbidity from I (healthy) through VI (brain-dead donor); higher classes predict sedation risk and often prompt anesthesia involvement.

Endocarditis prophylaxis indication

Antibiotics before endoscopy only for high-risk cardiac conditions such as prosthetic valves, prior infective endocarditis, or certain unrepaired congenital heart disease.

Moderate sedation

Drug-induced depression of consciousness in which patients respond purposefully to verbal or light tactile stimulation while maintaining spontaneous ventilation and airway reflexes.

Capnography monitoring

Continuous measurement of exhaled carbon dioxide that detects hypoventilation earlier than pulse oximetry and is recommended during deep sedation.

Flumazenil reversal

Benzodiazepine antagonist given in 0.2 mg intravenous increments up to 1 mg; it may precipitate seizures in chronic users and requires monitoring for resedation.

Fasting before sedation

Minimum of 2 hours for clear liquids and 6 hours for light solids to reduce aspiration risk before procedural sedation.

Prague classification

System describing Barrett esophagus by circumferential and maximal extent of columnar mucosa above the gastroesophageal junction, measured in centimeters.

Seattle biopsy protocol

Four-quadrant jumbo biopsies every 1-2 cm along the Barrett segment, plus targeted biopsies of visible lesions, to detect dysplasia or cancer.

Forrest classification

Endoscopic grading of peptic ulcer stigmata: Ia spurting, Ib oozing, IIa visible vessel, IIb adherent clot, IIc flat spot, and III clean base.

Los Angeles classification

Grading of erosive esophagitis from A (mucosal breaks under 5 mm) to D (breaks involving at least 75 percent of the circumference).

Adenoma detection rate

Proportion of screening colonoscopies in which at least one adenoma is removed; benchmarks are 25 percent overall, 30 percent in men, and 20 percent in women.

Cecal intubation landmarks

Appendiceal orifice, ileocecal valve, and triradiate fold confirm complete colonoscopy; photographic documentation is a recognized quality metric.

Post-polypectomy surveillance

Interval based on findings: 1-2 low-risk adenomas 7-10 years; 3-4 adenomas or a lesion 10 mm or more 3 years; 5 or more or high-grade dysplasia 1 year.

Epinephrine injection hemostasis

Submucosal injection of dilute epinephrine at 1:10,000 producing vasoconstriction and tamponade; usually temporary and combined with a second modality.

Through-the-scope clip

Deployable metallic clip used to compress bleeding vessels or close small defects, preferred for visible vessels and high-risk ulcer stigmata.

Variceal band ligation

Endoscopic placement of rubber bands on esophageal varices, repeated every 2-4 weeks until eradication, combined with vasoactive therapy and antibiotics acutely.

Hemostatic powder

Inert mineral powder sprayed onto bleeding lesions to form a mechanical barrier, useful for malignant or diffuse bleeding refractory to clips.

Post-ERCP pancreatitis prophylaxis

Rectal indomethacin 100 mg, aggressive lactated Ringer hydration, and prophylactic pancreatic stent placement in high-risk patients reduce pancreatitis risk.

Choledocholithiasis risk stratification

Very strong predictors include a common bile duct stone on imaging or cholangitis; strong predictors include a dilated duct plus bilirubin above 1.8 mg/dL.

Self-expandable metal stent

Larger-diameter biliary stent with longer patency than plastic stents, preferred for malignant obstruction, available in covered and uncovered designs.

EUS-guided FNA

Fine-needle aspiration under endoscopic ultrasound guidance for cytologic sampling of pancreatic masses, lymph nodes, and subepithelial lesions.

Cyst fluid CEA

Carcinoembryonic antigen level in pancreatic cyst fluid; values above 192 ng/mL suggest a mucinous cyst rather than a serous or inflammatory cyst.

Linear echoendoscope

Ultrasound endoscope with a side-viewing array that allows needle passage through the working channel for aspiration and drainage procedures.

Capsule endoscopy retention

Failure of the video capsule to pass a stricture; risk is assessed with a patency capsule in patients with suspected small bowel stenosis.

Double-balloon enteroscopy

Deep small bowel endoscopy using a balloon-mounted overtube and scope to pleat the intestine, enabling biopsy, hemostasis, and dilation.

Endoscopic submucosal dissection

En bloc resection using submucosal injection and electrosurgical knives that allows curative removal of early gastrointestinal neoplasia regardless of lesion size.

High-level disinfection

Killing of all microorganisms except high numbers of bacterial spores, achieved by soaking endoscopes in glutaraldehyde or an equivalent agent.

Duodenoscope reprocessing

Requires meticulous manual cleaning of the elevator mechanism, high-level disinfection or sterilization, and often microbiologic surveillance culture under regulatory guidance.

Colonoscopy perforation rate

Approximately 0.1-0.2 percent for diagnostic colonoscopy and higher with therapeutic intervention, most often at the sigmoid or cecum.

Informed consent documentation

Recorded discussion of indication, benefits, risks, alternatives, and sedation plan, signed before the procedure and filed with the endoscopy report.