Lower Endoscopy Procedures Flashcards

Six hours after colonoscopy with a large polypectomy, a patient has localized abdominal pain, fever, and leukocytosis, but CT shows no free air. What is the most likely diagnosis?

Answer: Post-polypectomy coagulation syndrome

Post-polypectomy coagulation syndrome is a transmural burn causing localized peritoneal signs without free air, and it is usually managed conservatively.

For a 6 mm sessile colorectal polyp, which resection technique is currently preferred?

Answer: Cold snare polypectomy

Cold snare polypectomy is recommended for small polyps (under 10 mm) because it removes them more completely and causes less delayed bleeding and thermal injury.

How deep can a standard flexible sigmoidoscope reach from the anal verge?

Answer: About 60 cm

A flexible sigmoidoscope is roughly 60 cm long and usually reaches the descending colon or splenic flexure.

An older patient has massive abdominal distension and a coffee-bean sign on X-ray without peritonitis. What procedure is the GI nurse most likely to help with?

Answer: Flexible sigmoidoscopic detorsion and decompression of sigmoid volvulus

Uncomplicated sigmoid volvulus is first treated with endoscopic detorsion and decompression, often leaving a decompression tube in place.

Before giving neostigmine for acute colonic pseudo-obstruction (Ogilvie syndrome), what equipment must be at the bedside?

Answer: Atropine and cardiac monitoring for bradycardia

Neostigmine can cause profound bradycardia, so continuous cardiac monitoring and atropine are needed.

When the scope keeps looping in the transverse colon, where does the nurse usually apply abdominal pressure to help it advance?

Answer: Mid-abdomen or periumbilical area, pushing upward

Upward pressure near the umbilicus supports a sagging transverse colon and reduces loop formation.

Which colonoscopy quality metric is most strongly linked to a lower rate of interval colorectal cancer?

Answer: Adenoma detection rate (ADR)

Each 1% increase in ADR is associated with about a 3% drop in interval colorectal cancer risk.