Acute GI bleeding Flashcards
Mechanical ventilation more than __ hours is a risk factor for ulcer/GI bleeding
48
INR > __ is risk factor for bleeding
1.5
Platelets < __ K is risk factor for bleeding
50
According to the El-Kersh study eating alone is enough to prevent significant bleeding and probably don’t need PPI
a. true
b. false
a. true
According to the Huang meta analysis in pts receiving enteral feeding, pharmacologic SUP is not beneficial
a. true
b. false
a. true
may increase risk of nosocomial pneumonia
Sucralfate limitations:
- DDIs
- may clog feeding tubes
- electrolyte abnormalities (Al accumulation, hypophosphatemia)
- constipation
Antacids provide no mortality benefit
a. true
b. false
a. true
H2RAs should be renally adjusted for CrCl < _ mL/min
50
H2RAs may __ the incidence of pneumonia
a. increase
b. decrease
a. increase
H2RAs may have what serious AE?
thrombocytopenia
PPIs may cause increased incidence of __ associated diarrhea
C diff
may increase pneumonia incidence
PPIs are much better at preventing a drop to 4 or lower pH, but no difference in preventing bleeding when compared to H2RAs
a. true
b. false
a. true
There is no difference in mortality rate between PPIs and placebo in ICU pts
a. true
b. false
a. true
Other risk factors for stress ulcers:
Hx of GI bleeding hypotension hepatic failure trauma severe thermal injury head injury spinal cord injury
What is main pre-endoscopic Tx for PUD?
IV proton pump inhibitor
Which is used for intermittent dose IV PPI therapy for PUD?
a. pantoprazole
b. esomeprazole
a. pantoprazole
Pantoprazole intermittent dose forIV PPI therapy?
40mg IV BID
High dose IV PPI therapy for PUD with pantoprazole and esomeprazole?
80mg IV bolus followed by 8mg/hr
Sucralfate is the preferred Tx for PUD post-endoscopic therapy
a. true
b. false
b. false
limited to no efficacy
Guidelines recommend against the use of H2RAs in the setting of upper gastric bleed
a. true
b. false
a. true
___ are shown to decrease rebreeding, need for surgery, and possibly mortality
a. H2RAs
b. PPIs
c. sucralfate
d. antacids
b. PPIs
no real mortality benefit
High dose PPIs infusion is used for__ hours after endoscopy
72
There are no specific therapies for lower GI bleeds
a. true
b. false
a. true
Limit NSAIDs, antiplatelets
PPI unlikely to have a difference
PPIs are unlikely to have a difference with lower GI bleed
a. true
b. false
a. true
