VideoGIE Image Quiz

  1. Dominant PSC stricture

    A 71-year-old man with primary sclerosing cholangitis presented with fatigue and jaundice. His CA 19-9 was normal. MRI showed narrowing of the common hepatic duct (CHD) and beading of the intrahepatic ducts. Cholangioscopy showed a dominant stricture in the CHD as shown. What is the next best step in management?
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  2. A UGI unknown

    A 76-year-old woman with a history of anaplastic thyroid cancer treated with radical thyroidectomy presents with failure to tolerate oral intake, recurrent vomiting, and progressive weight loss. An upper GI series was completed as shown in the image. Which of the following statements is true?
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  3. An unexpected finding

    A 74-year-old man presents with post-prandial epigastric discomfort. He recently had a negative colonoscopy. Upper endoscopy reveals a 6-cm pedunculated lesion growing from the duodenal bulb. After an endoscopic ultrasound evaluation of the polyp, endoscopic submucosal dissection is performed. Pathology reveals a hamartomatous polyp. Which of the following is the most appropriate next step in management?
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  4. A repeat customer

    A 78-year-old man with a cardiac history and taking an anti-platelet agent presents with recurrent diverticular bleeding. This was previously treated with multiple endoclips. He is hemodynamically stable, and his hemoglobin is 6.8 gm/dL. Which of the following is appropriate management of this patient?
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  5. A spoonful of sugar helps the medicine go down?

    A 21-year-old woman with a binge-purge type anorexia nervosa presents to the ER after accidentally swallowing the spoon she was using to induce vomiting. The object was successfully removed using a double channel scope and alligator forceps and snare. Which of the following situations would warrant an emergent endoscopy with foreign body extraction?
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  6. Burn that Barrett’s

    A 61-year-old woman with GERD has C8M8 Barrett’s esophagus with low-grade dysplasia. She presents for endoscopic eradication therapy with hybrid APC. Which of the following is a known risk factor for progression to adenocarcinoma?
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  7. A capsule capture

    What finding does this image recorded during specialized capsule endoscopy show?
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  8. Relief of obstructive jaundice

    An 82-year-old man presented with obstructive jaundice from gallbladder cancer. An endoscopic procedure was performed to improve his symptoms. Based on the available images, which of the following best describes the procedure that was completed?
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  9. A cholangiogram conundrum

    A 98-year-old man presents with abdominal pain and jaundice. He underwent ERCP. Initial cholangiogram is shown with multiple filling defects in the duct. Follow-up showed persistence of an intraductal finding. What is the next best step?
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  10. Harrowing hematemesis

    A 49-year-old man with end-stage renal disease presented with hematemesis and shock. He underwent an emergent EGD, which revealed high-risk varices in the proximal esophagus. Which statement is true?
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