Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Gastrointestinal Pathology > Acute GI Bleeding > Flashcards

Acute GI Bleeding Flashcards

1
Q

What areas affected can cause upper GI bleeding?

A

Oesophagus
Stomach
Duodenum

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

Upper GI bleeding location in relation to the ligament of Tritez

A

Proximal

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

Lower GI bleeding location in relation to the ligament of Tritez

A

Distal

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

What areas affected can cause lower GI bleeding?

A

Distal to duodenum

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

Causes of oesophageal bleeding

A

Oesophageal varices
Mallory Weiss Tear
Oesophageal malignancy
Ulcers

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

Causes of stomach bleeding

A 
Gastric varices
Gastric malignancy (may be under an ulcer)
Dieulafoy 
Angiodysplasia (tends to be chronic)
Ulcers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Causes of duodenal bleeding

A

Ulcers

Angiodysplasia (chronic)

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

When does inflammation in the upper GI tract tend to bleed?

A

In the context of abnormal clotting

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

Most common causes of an acute upper GI bleed

A 
Gastric cancer
Peptic ulcer 
Mallory-Weiss teat
Oesophagitis
Duodenitis
Varices
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a Mallory-Weis tear?

A

A linear tear in the mucous membrane where the oesophagus meets the stomach (oesophago-gastric junction)

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

What does melaena indicate?

A

Upper GI bleeding

As blood is digested and passed through

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

What does an elevated urea indicate in bleeding?

A

Partially digested blood > haem > urea = Upper GI bleeding

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

What are upper GI bleeding associated symptoms?

A

Dyspepsia
Reflux
Epigastric pain

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

Common cause of upper GI bleeding

A

NSAID use e.g. ibuprofen

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

Presentation of upper GI bleeding

A

Haematemesis
Melaena
Elevated urea

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

Presentation of lower GI bleeding

A

Fresh blood / clots
Magenta stools
Normal urea (rarely elevated in proximal small bowel)
Typically painless

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

Who is lower GI bleeding more common in?

A

Advanced age

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

Presentation of a peptic ulcer with an acute upper GI bleed

A 
Dyspepsia
Weight loss 
Collapse
Poor urine output
Large volume melaena or haematemesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which of duodenal or gastric ulcers are more common?

A

Duodenal

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

Risk factors for peptic ulcers

A

H pylori
NSAIDs/Aspirin
Alcohol excess
Systemic illness - “stress ulcers”

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

What may gastric ulcers sit over?

A

Gastric carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Zollinger-Ellison syndrome and what does it cause?

A

Gastrin secreting pancreatic tumour

Causes recurrent poor healing duodenal ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When does gastritis and duodenitis tend to bleed?

A

In the context of impaired coagulation

  • medical conditions
  • anti coagulants (e.g. warfarin)
  • anti platelets (e.g. clopidogrel)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Causes of oesophagitis causing upper GI bleeding

A 
Reflux oesophagitis
Hiatus hernia
Alcohol 
Bisphosphonates
Systemic illness 
Anti platelets/coagulants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are varices secondary to?
Portal HTN, usually due to liver cirrhosis
26
What are varices?
Abnormally dilated collateral vessels
27
Where are varices commonly found?
Oesophageal (90%) Gastric (8%) Rectal and splenic (rare)
28
Presentation of a Mallory-Weiss tear
Period of retching / vomiting | Haematemsis / melena
29
What is diuelafoy?
Submucosal arterial vessel eroding through the mucosa | Gastric fundus
30
What is an angiodysplasia?
Vascular malformation - degeneration, friable and bleeds easily
31
Where does an angiodysplasia occur?
Anywhere in the GI tract
32
What type of bleeding can angiodysplasia cause?
Chronic occult or overt occult bleeding
33
Colonic causes of acute lower GI bleeding
``` Diverticular disease Haemorrhoids Vascular malformation (angiodysplasia) Neoplasia (carcinoma or polyps) Ischaemic colitis Radiation enteropathy/proctitis IBD ```
34
Investigations of lower GI bleeding
Flexible sigmoidoscopy | Full colonoscopy
35
What is diverticular disease?
Protrusion of the inner mucosal lining through the outer muscle layer forming a pouch
36
Diverticulosis vs diverticulitis
``` Diverticulosis = presence Diverticulitis = inflammation ```
37
Bleeding in diverticular disease
10-20% during lifetime 10% chance of recurrence at 1 year 25% chance of reoccurrence at 4 years
38
What % of diverticular disease is self limiting?
75%
39
What are haemorrhoids?
Enlarged vascular cushions around the anal canal
40
When do haemorrhoids become painful?
If thrombosed | If external
41
Associations of haemorrhoids
Straining Constipation Low fibre diet
42
Treatment of haemorrhoids
Elective surgical intervention
43
What is ischaemic colitis?
Disruption to the blood supply in the colon
44
Complication of ischaemic colitis
Gangrene | Perforation
45
What type of abdominal pain presents with ischaemic colitis?
Crampy abdo pain
46
What does the mucosa look like in ischaemic colitis?
Dusky blue | Swollen mucosa
47
Radiotherapy for what commonly can cause radiation proctitis?
Cervical cancer | Prostate cancer
48
Treatment of radiation proctitis
APC Sulcrafate enemas Hyperbaric oxygen May need blood transfusion due to chronic loss
49
Small bowel causes of acute lower GI bleeding
``` Meckel's diverticulum Small bowel angiodysplasia Small bowel tumour/GIST Small bowel ulceration (NSAID assosiated) Aorto-entero fistulation ```
50
Investigations for a small bowel cause of acute lower GI bleeding
CT angiogram Meckles scan Capsule endoscopy Double balloon enteroscopy
51
Major haemorrhage protocol for GI bleeding
1. Resus with ABCDE approach 2. Consider blood transfusion if Hb < 7g/dl 3. Risk stratification for placement in HDU 4. Endoscopy once stable - within 24 hours 5. Withhold/reverse contributory medications as able e.g. vit K if on warfarin 6. Specific meds 7 Consider CT angiography/interventional radiology/surgical intervention as appropriate
52
What is shock?
Circulatory collapse resulting in inadequate tissue oxygen delivery leading to global hypoperfusion and tissue hypoxia
53
Signs of shock dude to haemorrhage
``` High RR High HR Anxiety or confusion Cool clammy skin Low urine output Low BP ```
54
What risk stratification scores are used for upper GI bleeding?
Rockall score | Blatchford Score
55
What does the Rockall score look at?
``` Age Shock Co-morbidity Diagnosis Major stigmata of recent haemorrhage ```
56
What does the Blatchford score look at?
``` Pre endoscopy score - blood urea - Hb - BP - hepatic disease - cardiac failure Then decide if need endoscopy ```
57
Who does acute lower GI bleeding most commonly occur in?
Elderly
58
The presence of how many co morbid conditions doubles the chances of a severe bleed?
2
59
Treatment of GI bleeding due to a peptic ulcer
PPIs Endoscopy with endotherapy Angiography with embolization Laparotomy
60
Treatment of upper GI bleeding due to variceal bleeding
``` Endotherapy Oesophageal band ligation or glue injection Gastric - glue injection Rectal - glue injection Ideally intubated for airway protection IV Terlipressin IV broad spectrum antibiotics ```
61
What does IV terlipressin do?
Vasoconstrictor of sphlanchnic blood supply | - reduces blood flow to portal vein, reducing portal pressures
62
What is used in the prophylaxis of variceal haemorrhage?
Propanolol
63
Who is a Mallory weis tear common in?
Alcoholics

Gastrointestinal Pathology (26 decks)

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