GI

Question 1

Haematemesis location

Answer 1

Upper GI tract

especially oesophagus and stomach

Question 2

Melaena location

Answer 2

Oesopohagus to ligament of trietz

but can be up to caecum

Question 3

Fresh PR bleeding or blood mixed with stool

Answer 3

Lower GI tract large bowel

Question 4

Causes of GI bleed

Answer 4

oesophageal varices
oesophagitis
oesophageal ulcers
oesophageal cancer
Mallory Weiss tear
Peptic ulcer
Stomach cancer
Dieulafoy lesion
Portal hypertension with gastric varices
NSAIDS SSRI
Gastritis
Duodenal ulcers
vascular malformations

Question 5

Causes of peptic ulcers

Answer 5

H Pylori
NSAIDS
physiological stress
smoking
zollinger-ellison syndrome

Question 6

Test for H pylori

Answer 6

Blood antibody test
Urea breath test
Stool antigen test

Question 7

Treatment H pylori

Answer 7

Triple therapy

• Amoxicillin
• Clarithromycin
• PPI

Question 8

What are varices

Answer 8

dilated veins at the junction between portal and systemic circulation

Question 9

Causes of portal hypertension

Answer 9

chronic liver disease
corrhosis
massive fatty change
portal vein thrombosis

Question 10

Treatment oesophageal varices non emergency

Answer 10

Terlipressin
prophylactic antibiotics
band ligation
TIPS

Question 11

treatment of oesophageal varices emergency

Answer 11

Sengstaken-Blakemore tube

Question 12

Mallory Weiss tear cause

Answer 12

excess retching and vomiting

• food poisoning
• alcoholism
• bulimia

Question 13

Management upper GI bleed

Answer 13

Oxygen if low
fluids with large bore cannulae
review with surgical team
consider OGD with glasgow blatchford score

Question 14

investigation results for GI bleed

Answer 14

microcytic anaemia

increased urea due to digested blood

Question 15

Guidelines for warfarin reversal

Answer 15

INR >8.0

or active bleeding/severe bruising

Question 16

score for deciding OGD

Answer 16

Glasgow blatchford score

Question 17

Score for predicting rebleed of GI

Answer 17

Rockall