GI bleeding

Question 1

define upper GI bleeding ?

Answer 1

bleeding derived from a source proximal to the ligament of Treitz ( originating from the oesophagus,stomach or duodenum)

Question 2

what are the oesophageal causes of bleeding ?

Answer 2

Mallory-weiss tears
Varices
Oesophagitis
malignancy

Question 3

what are the gastric causes of bleeedding ?

Answer 3

varicies
ullcerationn
gastritis
malignancy

Question 4

what are the usual causes of mallory-weiss syndrome ?

Answer 4

alcoholism
retching
coughing
vomiting
may also be associated with severe morning sickness in pregnanncy

Question 5

if there is ongoing bleeding due to mallory-weiss tears what is thee best managemeent ?

Answer 5

oesophageal clips
sclerotic agents

Question 6

what is the most common cause of oesophagitis ?

Answer 6

GORD

Question 7

how is pernicious anemia diagnosed ?

Answer 7

autoimmune disease - atrophic gastritis
antibodies for both parietal cell and intrinsic factor

Question 8

patient with GI bleeding and history of aortic-aneurysm repair, what is the most probable diagnosis ?

Answer 8

aortoenteric fistula

Question 9

what is a dieulafoy lesion ?

Answer 9

a large artery in the submucosa of either the stomach or the duodenum that bleeds.
reaches the mucosa and bleeds

Question 10

what are examples of anticoagulants ?

Answer 10

warfarin
pradaxa
xarelto

Question 11

what are examples of antiplatelet drugs ?

Answer 11

clopidogrel

Question 12

what should be done before endoscopy to prepare the patient ?

Answer 12

asses if the patient is haemodynamically stable or not
IV PPI
IV erythromycin
maintain an IV access

Question 13

when measuring vitals for a patient with UGIB, what must be noted ?

Answer 13

pulse and blood pressure should be checked with the patient in supine and upright position , any changes in vital signs with postural changes indicate an acute blood loss of app 20% or more

Question 14

what findings in a nasogastric tube confirm recent UGIB ?

Answer 14

coffee ground aspirate

Question 15

what is the management of variceal bleeding ?

Answer 15

1- resuscitate the patient
2- IV octreotide (somatostatin), vasopressin or terlipressin
3- Give antibiotics
4- perform band ligation through endoscopy within 24 hours
5- maintain patient on beta blockers most commonly propranolol is used

ensure to stop anticoagulants and NSAIDS
group and save to ensure that there is blood for the patient

if endoscopic therapy fails then TIPS
if TIPS fail then liver transplant

Question 16

what is the main complication of TIPS ?

Answer 16

hepatic encephalopathy

Question 17

what is mainly used for the management of gastric varicies ?

Answer 17

injection using n-butyl-cyanoacrylate ( superglue)

Question 18

what are the usual causes of mallory-weiss syndrome ?

Answer 18

alcoholism
retching
coughing
vomiting
may also be associated with severe morning sickness in pregnanncy

Question 19

what is Mallory-Weiss syndrome ?

Answer 19

bleeding tears in the mucosa at the gastroesophageal junction
most heal spontaneously within 24 to 48 hours

Question 20

presentation of patient with oesophageal varicies ?

Answer 20

haematemesis
coffee ground vomit
melena
jaundice
ascites

Question 21

whatt is the presentation for a bleeding peptic ulcer ?

Answer 21

haematemesis
coffee ground vomit
melena
epigastric pain
dyspepsia

Question 22

what is Mallory-Weiss syndrome ?

Answer 22

bleeding tears in the mucosa at the gastroesophageal junction
most heal spontaneously within 24 to 48 hours

Question 23

what are the usual causes of mallory-weiss syndrome ?

Answer 23

alcoholism
retching
coughing
vomiting
may also be associated with severe morning sickness in pregnanncy

Question 24

what are the usual causes of mallory-weiss syndrome ?

Answer 24

alcoholism
retching
coughing
vomiting
may also be associated with severe morning sickness in pregnanncy

Question 24

what is Mallory-Weiss syndrome ?

Answer 24

bleeding tears in the mucosa at the gastroesophageal junction
most heal spontaneously within 24 to 48 hours