Gastroenterology 14 - Upper GI Bleed

Question 1

4 causes of upper GI bleed

Answer 1

oesoph varices
Mallory Weiss tear (hard vom)
peptic ulcers
gastric/duod cancer

Question 2

4 aspects of upper GI presentation

Answer 2

frank haematemesis
coffee ground vomiting
melaena - offensive lol
haemodynamic instability (but in young may be a late sign!!)

Question 3

2 symptoms alongside upper GI bleed pointing to cause

Answer 3

epigastric pain - ulcer

jaundice or ascites - varices

Question 4

which score assesses risk of upper GI bleed?

Answer 4

Glasgow-Blatchford score
drop in Hb
raised urea
BP
HR
melaena
syncope

Question 5

what score is used to assess risk of bleeding post endoscopy?

Answer 5

Rockall

accounts for findings + co morbid

Question 6

6 key steps in managing acute GI bleed

Answer 6

ABCDE + resus 
Bloods send
Access (2 large bore)
Transfuse 
Endoscopy within 24 hrs
Drugs stop (NSAID, anticoag)

Question 7

which bloods should be ordered with upper GI bleed? 5

Answer 7

FBC - Hb
U+Es - urea
coag - INR, FBC
LFTs
crossmatch 2 units (they actually store it!)

Question 8

when would you give platelets?

Answer 8

active bleeding or platelets <50

Question 9

what is transfused in major haemorrhage?

Answer 9

blood, platelets, FFP

Question 10

definitive treatment for upper GI bleed

Answer 10

OGD!~