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Alimentary System > Acute GI Bleeding > Flashcards

Acute GI Bleeding Flashcards

1
Q

What is haematemsis?

A

Vomiting blood

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2
Q

What is melaena?

A

Jelly like black tarry stools

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3
Q

Where is the bleed suggested in haemetemesis?

A

Upper GI

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4
Q

Where is the bleed suggested melaena?

A

Upper GI

Blood has been digested as passing through the gut

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5
Q

What are some oesophageal causes of upper GI bleeding?

A

Oesophageal varices
Oesophageal malignancy
Ulcers
Mallory Weiss Tar

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6
Q

What are some gastric causes of upper GI bleeding?

A

Gastric varices (due to portal hypertension)
Gastric malignancies
Dieulafoy
Submucosal arteriolar vessel eroding through the mucosa
Gastric funduse
ULCERS

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7
Q

What are duodenal causes of upper GI bleeding?

A

Angiodysplasia
Vascular malformation
Ulcers

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8
Q

What is the most common cause of upper GI bleeding?

A

Ulcers

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9
Q

What are more common duodenal or gastric ulcers?

A

Duodenal

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10
Q

What is mallory weiss tear?

A

Tear where the oesophagus meets the stomach

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11
Q

What are risk factors for peptic ulcers?

A

H.pylori infection
NSAIDS
Alcohol excess
Systemic illness

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12
Q

What is the link between gastric ulcers and gastric carcinoma?

A

Gastric ulcers can sit over gastric carcinomas

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13
Q

What are oesophageal varices second to?

A

Secondary to portal hypertension

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14
Q

What is portal hypertension usually due to?

A

Liver cirrhosis

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15
Q

Why are oesophageal varices so serious?

A

Can rupturing can cause severe haemorrhage

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16
Q

What are the 2 main symptoms of oesophageal cancer?

A

Dysphagia

Weight loss history

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17
Q

What are the key HPC questions for the abdomen?

A 
Dyspepsia?
Weight loss 
Collapse 
Poor urine 
Melaena 
Haematemesis
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18
Q

What are the key PMH questions for the abdomen?

A

History of liver disease?

19
Q

What are the key D&A questions for the abdomen?

A

NSAIDS
Steroids
Anti-coagulants
Anti-platelets

20
Q

What are the key SH questions for the abdomen?

A

Alcohol

Smoking history

21
Q

Where is lower GI bleeding classed from?

A

Bleeding distal to duodenum

22
Q

What is the typical presentation of a lower GI bleed?

A

Fresh blood in stools

23
Q

What are some potential causes for lower GI bleeding?

A 
Diverticular disease
Haemorrhoids 
Vascular malformations 
Neoplasia 
Ischamia colitis 
Radiation enteropathy 
IBS
24
Q

What does diagnosis for lower GI bleeding require?

A

Flexible sigmoidoscopy

or full colonoscopy

25
Q

What is diverticular disease?

A

When there is protrusion of the inner mucosal lining through the outer muscular layer

26
Q

What is diverticulits

A

Inflammation in diverticular disease

27
Q

What % of diverticulitis is self limiting?

A

75%

28
Q

Who are haemorrhoids more common in?

A

Younger people

29
Q

What are haemorrhoids?

A

Enlarged vascular cushions around the anal canal

30
Q

What causes ischeamic colitis?

A

Disruption to the blood supply of the colon

31
Q

Which part of the bowel is affected in ischaemic bowel disease?

A

Depends on if the SMA or IMA is affected

32
Q

What is the appearance of the bowel on colonoscopy in ischamic colitis?

A

Bruise like appearance

Dusky blue

33
Q

What are the 2 categories of IBD?

A

Ulcerative Colitis

Crohn’s Disease

34
Q

What appearance does IBD give on colonoscopy?

A

Cobblestone appearance

35
Q

What are some small bowel causes for GI bleeding?

A

Meckel’s diverticulum
Small bowel angiodysplasia
Small bowel tumour
Small bowel ulceration

36
Q

What is the first step to managing a GI bleed?

A

ABCDE approach

37
Q

What does A, B, C, D and E stand for?

A 
Airway 
Breathing 
Circulation 
Disability 
Exposure
38
Q

When should an endoscopy be performed on a patient experiencing a GI bleed?

A

Once ABCDE has been covered and the patient is stable

39
Q

What is shock?

A

Circulatory collapse resulting in inadequate tissue oxygen delivery leading to global hypoperfusion and tissue hypoxia

40
Q

In which age group does acute lower GI bleeding more commonly occur?

A

In the elderly

41
Q

How many co-morbidities need to be present to double a patients chance of a severe GI bleed?

A

2

42
Q

Which drugs increase the risk of a lower GI bleed?

A

NSAIDS

Aspirin

43
Q

Which investigations are appropriate for those experiencing acute abdominal pain?

A 
Xray 
Erect chest and abdominal xray 
Abdominal US 
CT scanning 
Contrast studies

Alimentary System (29 decks)

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