Blood in Vomit/Stools

Question 1

Cause of black color of melena?

Answer 1

Hemoglobin in the blood being altered by digestive chemicals and intestinal bacteria

Question 2

How much blood required to cause melena?

Answer 2

60mL

Question 3

Causes of black “non sticky” stools

Answer 3

Iron
Bismuth (Peptobismol)

Question 4

What can cause hematochezia

Answer 4

Usually a lower GI bleed but can also be a brisk upper GI bleed

Question 5

What is “currant jelly” stool

Answer 5

Mixed with blood and mucus

Question 6

What is currant jelly stool often associated with?

Answer 6

Intussusception

Question 7

What defines a GI bleed as upper or lower?

Answer 7

Proximal vs beyond ligament of Treitz

Question 8

Most common causes of lower GI bleed in neonates

Answer 8

Intussusception
Milk protein allergy
Bacterial enteritis

Question 9

Most common cause of lower GI bleed in infants

Answer 9

Anal fissures (most common)
Volvulus

Question 10

What are the most common causes of lower GI bleed in adults and elderly?

Answer 10

Diverticulitis
Colitis (UC>Crohn’s)
Neoplasia (colon, rectum, anus)
Anorectal disease (hemorrhoids, anal fissures)

Question 11

Most common causes of upper GI bleeds in children?

Answer 11

GERD - most common
Gastritis s/t H. Pylori

> 12 years:
-duodenal ulcers
-MW tears

Question 12

Most common causes of upper GI bleed in adults and elderly

Answer 12

PUD - most common
MW tear
Erosive gastritis