Acute gastrointestinal bleed

Question 1

Meds RFs for GI bleed

Answer 1

• NSAIDs
• steroids
• anticoagulants

Question 2

A syndrome characterised by tearing of the mucus membrane at the gastroesophageal junction which leads to upper GI bleed

Answer 2

Mallor Weiss syndrome

Question 3

A syndrome characterised by pigmented lesions that has a high risk of progressing into cancer that can cause a lower GI bleed

Answer 3

Peutz-Jeghers syndrome

Question 4

GI bleed symptoms local to abdomen

Answer 4

• abdo pain
• haematemesis
• melena
• haematochezia

Question 5

HD instability symptoms of GI bleeding

Answer 5

• fatigue
• confused
• tachycardia
• hypotension

Question 6

What does the Rockall score measure

Answer 6

Risk of bleeding & overall mortality after endoscopy

Question 7

In a Glasgow-Blatchford score, what score places patients at higher risk and therefore needing a medical intervention

Answer 7

> 0

Question 8

Why is it important to check haemoglobin when a GI bleed is suspected

Answer 8

Anaemia

Question 9

Explain the raised urea in GI bleed

Answer 9

Urea one of components of blood breakdown —> absorbed by GIT

Question 10

The source of bleeding can be found with

Answer 10

Endoscopy

Question 11

Most usual tx for GI bleed

Answer 11

Self limiting

Question 12

Why would you advise a patient with upper GI bleed to nil by mouth

Answer 12

Undergo endoscopy

Question 13

Tx of oesophageal variceal veins

Answer 13

Band ligation

Question 14

Tx of gastric variceal veins

Answer 14

Cyanoacrylate

Question 15

What 2 meds would u give prophylactically in GI bleed

Answer 15

• BS Abx

- terlipressin

Question 16

Management for non-variceal veins GI bleed

Answer 16

• endoscopy
• thermal coagulation
• fibrin
• thrombin

Question 17

Why is adrenaline administered in non-variceal veins GI bleed

Answer 17

Vasoconstriction

Question 18

When is angiography with embolisation performed in non-varcieal veins GI bleed

Answer 18

Rebleed & unstable

Question 19

ABATED in managing acute upper GI bleeds

Answer 19

• ABCDE approach
• Bloods
• Access (2 large bore cannulas)
• Transfuse
• Endoscopy - within 24 hrs
• Drugs - stop RFs

Question 20

med given as prophylaxis in GI bleed

Answer 20

non-cardioselective beta blockers

Question 21

Abx prescribed in acute variceal bleed

Answer 21

ceftriaxone

Question 22

in terms of GI bleeding, high levels of urea indicate

Answer 22

upper GI bleed

Question 23

AIMS65 score is used to calculate … by taking into consideration (3)

Answer 23

• in-hospital mortality in patients with upper GI bleed

- albumin levels, coagulation results, and degree of altered mental status

Question 24

when is Glasgow-Blatchford used

Answer 24

BEFORE endoscopy