๐ฎ๐ฐ ๐ฏ๐๐๐๐๐๐๐๐๐๐ Flashcards
What defines acute GI bleeding?
Bleeding less than 3 days duration with hemodynamic instability requiring blood transfusion
What is the difference between overt and occult GI bleeding?
Overt bleeding is visible (melena/bright red blood) while occult is only detected by lab tests
What percentage of GI bleeds are from upper sources?
75% of GI bleeds originate from upper sources
Which gender has a higher prevalence of upper GI bleeding?
More common in men (2:1 ratio)
What are three main types of ulcers causing upper GI bleeding?
Peptic ulcer duodenal ulcer and gastric ulcer
What is Mallory-Weiss tear?
A superficial longitudinal mucosal tear of the upper esophagus
What causes variceal bleeds in liver cirrhosis?
Portal hypertension leading to porto-systemic anastomosis development
What are the four main vital signs of hemodynamic instability in GI bleeding?
Pulse rate
Respiratory rate
Blood pressure
Mental state
What is the first priority in emergency management of GI bleeding?
ABC (Airway Breathing Circulation) with focus on C takes priority over finding diagnosis/cause
How is crystalloid fluid therapy given in GI bleeding?
3:1 ratio of the blood loss estimated using Ringerโs lactate given over 10-15 minutes
What lab tests should be ordered immediately in GI bleeding?
FBC clotting profile blood grouping and crossmatch
What are the three anatomical sites of lower GI bleeding?
Colon rectum and anus
What percentage of rectal bleeding cases in patients over 80 is due to colon cancer?
10% of cases in patients over 80 years
What is a key physical exam finding in GI bleeding suggesting shock?
Skin signs (color warmth moisture) to assess for shock
What social history factors increase risk of GI bleeding?
Alcoholism (risk of liver disease/variceal bleeding) and smoking (risk of PUD)
What is melena and what does it suggest?
Black tarry stools suggesting upper GI bleed
What color blood suggests rectal/anal source?
Bright red blood per rectum suggests rectal or anal source
What medication history is important in GI bleeding?
Antiplatelet or anticoagulant use that can exacerbate bleeding
What are the three main inflammatory causes of lower GI bleeding?
Colitis
Hemorrhoids
Inflammatory bowel disease
What are the vital signs to monitor during resuscitation?
Pulse rate
Blood pressure
Urine output
Level of consciousness
Temperature
When should you secure IV access in GI bleeding?
Immediately using 2 large-bore cannula in antecubital fossae
What indicates severity in GI bleeding?
Duration frequency and volume of bleeding
What would you like to ask in past medical history for GI bleeding?
โฆ๏ธPrevious GI bleeding
โฆ๏ธHx of ay disease that can cause GI bleeding e.g peptic ulcer disease
โฆ๏ธBleeding disorders
โฆ๏ธDrug hx (anti-coagulants or anti-platelets)
How do you assess severity of blood loss clinically?
By checking vital signs mental status and skin signs
