GI Flashcards
Occult blood
blood in the stool found through lab tests
Hematemesis
bloody emesis
Melena
dark, tarry stools
Hematochezia
bright red stools
Manifestations of upper GI bleeds
melena, hematemesis
Treatment of upper GI bleed
PPI, sucralfate, antacids, eliminate irritating foods
Prevention of upper GI bleed
keep gastric pH above 4, PPIs, sucralfate
Lead on upper GI bleed cases
gastroenterologist
Lead on lower GI bleed
general/colorectal surgeon
Diverticular bleeding - upper or lower
lower
Ischemic bowel disease - upper or lower
lower
Risk factors for diverticular bleeding
diverticulitis, rupture
Characteristics of diverticular bleeding
sustained, dark, occasional massive bleeding throughout the colon
Ischemic bowel disease
ischemia of the colon
What is ischemic bowel disease caused by
interruption of colonic blood supply
Treatment of ischemic bowel disease
restoration of blood circulation to the intestines
Clinical manifestations of ischemic bowel disease
intermittent dark and bright red blood per rectum, c. diff is present
What is prescribed for fluid replacement during acute gastrointestinal bleeding
crystalloids/colloids
When to admit to ICU for acute gastrointestinal bleeding
coffee ground emesis, hemodynamic instability, drop in hemoglobin/hematocrit, large increased in BUN
Management of acute gastrointestinal bleeding
maintain IV volume and tissue oxygenation
Meds for severe GI hemorrhage
vasopression, somatostatin, acterotide
What is the hallmark manifestation for acute intestinal obstruction
abdominal distension
s/s of acute intestinal obstruction
cramping, periumbilical pain that comes in waves, perfuse vomiting, electrolyte imbalances
Treatment for acute intestinal obstruction
fluid resuscitation –> broad spectrum antibiotics –> early surgical consult
What complications need to be monitored for
pain, tenderness, distension
Acute small bowel obstruction
intestinal strangulation interrupts circulation, progressing to bowel ischemia
