Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastroenterology yr 2 > Gastrointestinal bleeding > Flashcards

Gastrointestinal bleeding Flashcards

1
Q

what is melena caused by

A

oxidation of Hb as it passes lower GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Bleeding that originates proximal to ligament of treitz is

A

Upper GI bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Melena or hematemesis or brisk bleeding - hematochezia can suggest

A

upper GI bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Organs proximal to ligament of treitz

A

esophagus
stomach
duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Organs distal to ligament of treitz

A

jejunum
ileum
colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hematochezia or melena (from small bowel or right colon if slow) suggests

A

Lower GI bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MOST common causes of Upper GI bleed

A

1) PUD
2) Varices
3) Esophagitis
4) MW tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If bleeding is non-variceal how long will it last

A

80% will stop on their own

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

3 features make you worries about MASSIVE bleed

A

1) unstable hemodynamically
2) presents with hematochezia or frank hematemesis
3) blood transfusion needs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

3 features make you worries about WORSE outcome

A

1) > 60
2) concurrent illness
3) Onset WHILE hospitilized
4) coagulopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

First thing to do when managing an UGIB

A

1) resuscitate!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Second thing to do when managing an UGIB

A

PPIs - give IV Bolus-infusion

Octreotide - only for variceal bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

For all UGIBs what medical therapy is given

A

PPIs - octreotide for variceal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Third point in management of UGIB

A

Correct coagulopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Fourth thing done in management of UGIB

A

Endoscopy to localize/treat bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Resuscitation in UGIB

A

1) Airway
2) 2 LARGE bore peripheral IVs
3) Normal saline IV
4) packed RBC transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

PPIs act on which cell in the stomach

A

Parietal cell, block acid production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does the higher pH promote?

A

Clot stability

19
Q

3 roles for endoscopy

A

1) diagnose
2) prognosis risk/stratify lesion
3) treat lesion - therapy

20
Q

2 low risk lesions

A

clean base/flat spot - NO ENDOSCOPic therapy

21
Q

Example of an intermediate lesion

A

Adherent clot - - consider therapy

22
Q

2 examples of HIGH risk lesions

A

Nonbleeding, but visible vessels

or active bleeding - MUST TREAT

23
Q

Medications used in endoscopy

A
  • diluted Epi, Hemospray
24
Q

If you can’t stop the bleeding endoscopically

A

Angiography with embolization needed/surgery

25
Q

2 things happen when pressure goes up in portal system

A

1) Increased portal vascular resistance

2) Vasodilation and splanchnic blood flow

26
Q

What should the difference between portal and systemic pressures be to get varices

A

12 mmHg at least

27
Q

Clinical risk factor for variceal bleeding is

A

severity of liver disease

28
Q

Endoscopic predictors of variceal bleeding

A
  • size

- recent hemorrhage (wale marking, cherry spots)

29
Q

2 differences in treatment/management of varieal vs non-variceal blood

A
  • Give octreotide

- Give prophylactic antibiotics

30
Q

endoscopically what is different from PUD vs variceal bleed

A

Band ligation used more than sclerotherapy

31
Q

If band ligation fails can use

A

TIPS

32
Q

what is the mechanism of action of octreotide in reducing portal hypertension

A
  • vasoconstricts spanchnic vasculature

- given bolus-infusion

33
Q

what does a TIPS do?

A

shunts blood from portal vein to hepatic vein

34
Q

what are the risks of TIPs

A

encephalopathy, occlusion

35
Q

Difference between variceal and gastric varice?

A
  • use gluing rather than banding
36
Q

when do you suspect that someone has an upper GI bleed presenting with hematochezia

A
  • when hemodynamically unstable

- cirrhotic/NSAID/ Hx of PUD

37
Q

What are the causes of painless acute lower GIB

A
  • Diverticulosis
  • Hemorrhoids
  • angiodysplasia
  • colon cancer/polyp
  • Meckel’s
38
Q

Cause of a painful LGIB

A

anal fissure

39
Q

Causes of bloody diarrhea

A
  • infectious colitis
  • ischemic colitis
  • IBD
40
Q

4 causes of Acute Lower GIB

A
  • diverticulosis
  • angiodysplasia
  • ischemic colitis and hemorrhoids
  • neoplasia/other colitis
41
Q

Difference between UGIB and LGIB in terms of management

A
  • LGIB - do a colonoscopy to treat and localize lesion
42
Q

if a patient cannot undergo colonoscopy what to do?

A

send for angiography -

RBC scan first to screen for active bleed

43
Q

2 scans before you send patients to angiography

A

CT angio
or
RBC scan

Gastroenterology yr 2 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions