Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

The Alimentary Canal > Acute GI Bleeding > Flashcards

Acute GI Bleeding Flashcards

1
Q

Where is upper GI bleeding?

A

Oesophagus, stomach and duodenum
Proximal to ligament of Trietz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where is lower GI bleeding?

A

Bleeding distal to duodenum
Distal to ligament of Trietz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the clinical definition of upper GI bleeding?

A

Haematemesis, melaena, elevated urea (partially digested blood)
Associated with dyspepsia, reflux and epigastric pain
NSAID use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the clinical definition of lower GI bleeding?

A

Fresh blood/clots, magenta stools, normal urea
Typically painless and more common in advanced stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some causes of upper GI bleeding?

A

Ulcers and inflammation
Oesophageal and gastric varices, Mallory Weiss Tear, malignancy, angiodysplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the most common causes of upper GI bleeding?

A

Gastric cancer
Duodenal ulcer
Mallory-Weiss tear
Oesophagitis
Oesophageal varices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What questions are asked with peptic ulcers?

A

If any dyspepsia, haematemesis, collapse
Past medical history - liver disease
NSAIDs
Alcohol, smoking, injecting drugs
FH - peptic ulcers and h. pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is a peptic ulcer formed?

A

Injury to defence forces - mucus secretion and bicarbonate, submucosa damaged
Imbalance of natural defences to damaging agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the risk factors for peptic ulcers?

A

H. pylori
NSAIDs/ Aspirin
Alcohol excess
Systemic illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does H. pylori cause a peptic ulcer?

A

H. pylori penetrates mucus layer and adheres to surface
Urease converts urea to ammonia - buffers gastric acid to protect the infection
Proliferation
Gastric ulcer formed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does NSAIDs cause a peptic ulcer?

A

COX-1 inhibition - so no GI protection
COX-2 inhibition - causes increased damage and unable to heal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What should not be missed with peptic ulcers?

A

Gastric ulcers may sit over gastric carcinoma
Zollinger-Ellison syndrome causes recurrent poor healing duodenal ulcers due to acid overproduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does gastritis and duodenitis causes bleeding?

A

Bleed in context of impaired coagulation - medical conditions, anti-coagulants, antiplatelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What can cause oesophagitis?

A

Reflux oesophagitis, hiatus hernia, alcohol, bisphosphonates, systemic illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What increases risk of bleeding for oesophagitis?

A

Anti-platelets or anti-coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Explain varices

A

Secondary to portal hypertension and usually due to liver cirrhosis
Abnormally dilated collateral vessels
Increase in portal pressure can lead to life threatening bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What types of cancer can cause upper GI bleeding?

A

Oesophageal - typically ooze
Gastric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe Mallory-Weiss tear

A

Linear tear at oesophageal-gastric junction
Follows period of retching/vomiting
10% need endoscopic treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe diuelafoy

A

Submucosal arteriolar vessel eroding through mucosa
Gastric fundus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe angiodysplasia

A

Vascular malformation, occurs anywhere in GI, can cause chronic occult or overt bleeding
Associated with heart valve replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some colonic causes for acute lower GI bleeding?

A

Diverticular disease and haemorrhoids most common
Vascular malformations, neoplasia, ischaemic colitis, radiation enteropathy/proctitis, IBD

22
Q

What investigations are need for diagnosis when lower GI bleed?

A

Flexible sigmoidoscopy or full colonoscopy

23
Q

Explain diverticular disease

A

Protrusion of inner mucosal lining through the outer muscular layer forming a pouch
Diverticulosis - presence
Diverticulitis - inflammation
Risk of further bleeding

24
Q

What are haemorrhoids?

A

Enlarged vascular cushions around anal canal
Painful if thrombosed or external
Associated with straining, constipation and low fibre diet

25
What is the treatment for haemorrhoids?
Elective surgical intervention
26
What is the treatment for angiodysplasia?
Argon phototherapy - burns off blood vessel
27
What is a colonic neoplasia?
Colonic polyps or carcinoma Often preceding lower GI symptoms Very rare to cause a life threatening bleed
28
Explain Ischaemic colitis
Disruption in blood supply to colon Presents with crampy abdominal pain and self limiting Dusky blue and swollen mucosa
29
What are the complications of ischaemic colitis?
Gangrene and perforation
30
What is radiation proctitis?
Previous history of radiotherapy Crescendo PR bleeding May be dependant on blood transfusions due to chronic loss
31
What is the treatment for radiation proctitis?
APC Sucralfate enemas Hyperbaric oxygen
32
What are some small bowel causes of acute lower GI bleeding?
Meckel's diverticulum, angiodysplasia, tumour/GIST, small bowel ulceration and aortoentero fistulation
33
What investigations are used for the small bowel?
CT angiogram Meckel's scan Capsule endoscopy Double balloon enteroscopy
34
What is used to diagnose Meckel's diverticulum?
Nuclear scintigraphy - radio isotope Gastric reminant mucosa
35
What is involved in resuscitation of the patient?
Airway Breathing Circulation - IV access, blood samples, blood transfusion, catheter Disability Exposure
36
What is the definition of shock?
Circulatory collapse resulting in inadequate tissue oxygen delivery leading to global hypoperfusion and tissue hypoxia
37
Describe the haemorrhagic subtype
High resp. rate A rapid pulse Anxiety or confusion Cool clammy skin Low urine output Low blood pressure
38
What are the classifications of shock?
1-4 Depend on volume lost, HR, RR, BP, Pulse, conscious level and urine output
39
What is included in the risk stratification UGIB?
Age, shock, co-morbidity, diagnosis, major stigmata pf recent haemorrhage
40
What is the pre-endoscopy score for the Blatchford score?
Blood urea, haemoglobin sex differences, systolic blood pressure and heart rate Other markers - hepatic disease and cardiac failure
41
What is a low risk criteria for Glasgow Blatchford score?
Urea less than 6.5 mmol/l Haemoglobin more than 130g/l (men) and 120g/l (women) Systolic blood pressure more than 110mmHg Pulse less than 100 Absence of melaena, syncope, cardiac failure or liver disease
42
What does the score for the Glasgow Blatchford test suggest?
Over or equal to 6 associated with a greater than 50% risk of needing an intervention Scores lower than 2 consider discharge
43
What are more risks of lower GI bleed?
Age - occurs most often in elderly Co-morbidity - doubles chance of severe bleed Inpatients - rectal bleeding gives 23% mortality Drugs - NSAIDs and aspirin
44
How is upper GI diagnosed and treated?
Endoscopy then once stable consider therapeutic options
45
How is lower GI diagnosed and treated?
Colonoscopy or CT angiogram
46
What medications are given as treatment for GI bleeding?
Vitamin K and maybe beriplex if on warfarin PPI and tranexamic acid Then possible surgery
47
What is the management for peptic ulcers?
Endoscopy is diagnostic PPI Angiography with embolization Laparotomy
48
What are endoscopic therapies used for peptic ulcers?
Injection of adrenaline Thermal - gold probe which burns blood vessel Mechanical - clip (staples) Combination most effective - adrenaline and thermal or clips
49
When is angiography and laparotomy used for peptic ulcer?
If bleeding ongoing and uncomfortable endoscopically
50
What is the management for varices?
Endoscopy with endo-therapy Terlipressin, antibiotics and reverse abnormal coagulation Sengstaken-Blakemore tube TIPSS
51
What is terlipressin?
Vasoconstrictor of splanchnic blood supply Reduces blood flow to portal vein Reduces percentage of mortality
52
When is Sengstaken-Blakemore tube and TIPSS used for management?
If bleeding ongoing and uncontrollable endoscopically For varices Causes pressure on varices and blocks blood flow TIPSS- shunt across portal system

The Alimentary Canal (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions