GI Clinical Procedures & Protocols 3

Question 1

The Paris classification in endoscopy is used to describe:

Accepted Answer

The morphology and depth of superficial GI lesions

Answer

The Paris classification categorizes superficial neoplastic lesions (polypoid, flat, and depressed subtypes) in the GI tract to predict submucosal invasion risk.

Question 2

A patient with known coagulopathy (INR 2.8) requires diagnostic colonoscopy with possible biopsy. The most appropriate pre-procedure management is:

Accepted Answer

Administer vitamin K and repeat INR before proceeding

Answer

For elective procedures with bleeding risk, correcting INR with vitamin K to <1.5–2.0 is preferred over FFP unless there is urgent clinical need.

Question 3

During flexible sigmoidoscopy, resistance is encountered at the rectosigmoid junction. The recommended technique is:

Accepted Answer

Torque the scope and use abdominal pressure while withdrawing slightly

Answer

Paradoxical withdrawal with torque (jiggling technique) and external abdominal pressure straightens the sigmoid loop and allows scope advancement.

Question 4

Which scoring system is used intraoperatively or endoscopically to assess the extent of ulcerative colitis?

Accepted Answer

Baron Score

Answer

The Baron Score (0–3) assesses mucosal appearance at sigmoidoscopy/colonoscopy, grading from normal to spontaneous bleeding mucosa in ulcerative colitis.

Question 5

The 'pull' technique in PEG tube placement involves:

Accepted Answer

Pulling the tube from inside the stomach to the outside via a wire

Answer

In the pull technique, a guidewire is passed through the abdominal wall into the stomach and grasped endoscopically, then the PEG tube is attached and pulled back through the mouth and out the abdominal wall.

(GI) Gastrointestinal Practice Test

(GI) Gastrointestinal Practice Test

GI Clinical Procedures & Protocols 3