acute upper GI bleeding

Question 1

clinical features of acute upper GI bleeding

Answer 1

haematemesis
melena (black and tarry)
raised urea

Question 2

oesophageal causes of acute upper GI bleeding

Answer 2

oesophageal varices
oesophagitis
cancer
mallory weiss tear

Question 3

gastric causes of acute upper GI bleedign

Answer 3

gastric ulcer
gastric cancer
dieulafoy lesion
diffuse erosive gastritis

Question 4

duodenal causes of acute upper GI bleeding

Answer 4

duodenal ulcer
aorto-enteric fistula

Question 5

management of acute upper GI bleeding

Answer 5

glasgow-blatchford score/blatchford score
resus- ABC, wide bore cannula
platelet transfusion if actively bleeding platelet count
fresh frozen plasma (patients fibrinogen level of less than 1 or PTT greater than 1.5 times)
prothrombin complex concentrate to patients taking warfarin
endoscopy offer after resus

Question 6

management of variceal bleeding

Answer 6

terlipressin and prophylactic antibiotics
band ligation for oesophageal varices
injections of N-butyl-2-cyanoacrylate for patients with gastric varices
TIPS if bleeding still not controlled