GI Bleed

Question 1

What is hematochezia?

Answer 1

Bright red blood usually from the colon exiting the rectum. (it is NOT a rectal bleed)

Question 2

Why is measuring hematocrit not a great diagnostic tool in GI bleed?

Answer 2

Hematocrit will present in the normal range because the body has not compensated for the volume loss. A measurement 24 hrs. after the bleed would reveal severe anemia.

Question 3

What does GI bleed do to BUN levels?

Answer 3

Elevates BUN, albumins are degraded to urea

Question 4

Most common cause of upper GI bleed.

Answer 4

Peptic ulcer (duodenal or gastric)

Question 5

Rare cause of upper GI bleed resulting from vascular surgery.

Answer 5

Aorto-enteric fistula.
-if a person presents with history of aortic aneurysm and UGI bleed, the surgical correction of the aneurysm may have created the fistula.

Question 6

What is a Dieulafoy Erosion?

Answer 6

A large tortuous arteriole in the stomach wall that erodes and bleeds. It can cause gastric hemorrhage

Question 7

Which etiology of acute UGI bleed has the highest chance of rebleed and death?

Answer 7

Esophageal Varices

Question 8

Best treatment for UGI bleed.

Answer 8

IV PPI

Question 9

What is the main cause of hemobilia?

Answer 9

Liver pathology: trauma, biopsy, instrumentation, tumor, aneurysm

Question 10

Major causes of lower GI bleed.

Answer 10

1. Angiodysplasia

2. Diverticulosis

Question 11

Best 2 diagnostic tools for LGI bleed.

Answer 11

1. Colonoscopy

2. Angiography

Question 12

4 treatments for LGI bleed

uses diagnostic tools

Answer 12

Colonoscopy

1. electrocautery
2. laser
3. polypectomy

Angiography
4. Vasopressin

Question 13

What is Heyde Syndrome?

Answer 13

A syndrome of aortic valve stenosis associated with gastrointestinal bleeding from colonic angiodysplasia.