GI Clinical Procedures & Protocols 2

Question 1

Before performing a colonoscopy, the recommended bowel preparation solution for a patient with chronic kidney disease (CKD) is:

Accepted Answer

Polyethylene glycol (PEG) solution

Answer

PEG-based solutions are preferred in CKD patients because they do not cause significant electrolyte shifts, unlike sodium phosphate which can cause hyperphosphatemia and acute kidney injury.

Question 2

During an upper endoscopy (EGD), a patient develops sudden bradycardia and hypotension. The FIRST intervention should be:

Accepted Answer

Withdraw the endoscope and provide supplemental oxygen

Answer

Withdrawing the scope relieves vagal stimulation while supplemental oxygen addresses hypoxia, which are the most common causes of vasovagal responses during EGD.

Question 3

The Forrest classification is used during endoscopy to:

Accepted Answer

Stratify rebleeding risk of peptic ulcers

Answer

The Forrest classification (Ia through III) categorizes stigmata of recent hemorrhage in peptic ulcers to guide decisions about endoscopic hemostasis.

Question 4

A patient undergoes ERCP and develops abdominal pain with lipase 3× the upper limit of normal within 24 hours. This complication is classified as:

Accepted Answer

Mild post-ERCP pancreatitis

Answer

Mild post-ERCP pancreatitis is defined by new-onset pain with amylase or lipase ≥3× ULN at 24 hours requiring hospitalization for 2–3 days without organ failure.

Question 5

Endoscopic submucosal dissection (ESD) differs from endoscopic mucosal resection (EMR) primarily in that ESD:

Accepted Answer

Allows en bloc resection of larger lesions

Answer

ESD uses specialized knives to dissect the submucosal layer, enabling en bloc resection of lesions >2 cm that would require piecemeal removal with EMR.

(GI) Gastrointestinal Practice Test

(GI) Gastrointestinal Practice Test

GI Clinical Procedures & Protocols 2