Chapter 75: Upper Gastrointestinal Bleeding Flashcards
The most common cause of upper GI bleeding
Peptic ulcer disease
It is bleeding secondary to a longitudinal mucosal tear at the gastroesophageal junction
Mallory-Weiss syndrome
Are arteries of the GI tract that protrude through the submucosa
Dieulafoy lesions
Where is dieulafoy lesions commonly found?
Lesser curvature. Most are within 6cm within GE junction
The presence of melena and age <50 years old more likely indicate an ____
The presence of melena and age <50 years old more likely indicate an upper GI bleed
Most reliable way to diagnose upper GI bleeding in the ED
Visual inspection of the vomitus for a bloody, maroon, or coffee- ground appearance
The single most important laboratory test is to obtain in UGIB?
the single most important laboratory test is to obtain blood for type and cross-match
A BUN:creatinine ratio ____ suggests an upper GI source of bleeding
A BUN:creatinine ratio ≥30 suggests an upper GI source of bleeding
If endoscopy in unavailable what can be consider to be done?
Tagged red-cell scintigraphy or visceral angiography
How to give octeotide in UGIB?
50-microgram bolus then infusion of 25–50 micrograms/h
A restrictive transfusion threshold using hemoglobin concentrations of ____ in most patients
A restrictive transfusion threshold using hemoglobin concentrations of <7 grams/dL in most patients
An INR ____ is a significant predictor of mortality in patients with an upper GI bleed who are receiving anticoagulants
An INR ≥1.5 is a significant predictor of mortality in patients with an upper GI bleed who are receiving anticoagulants
Small studies showed reduce the risk of death in patients with upper GI bleeding
Tranexamic acid
How to give omeprazole drip?
Omeprazole 80 milligrams IV bolus followed by infusion of 8 milligrams/h
Prophylactic antibiotic for UGIB with liver problem
Ciprofloxacin 400 milligrams IV
Ceftriaxone 1 gram IV
