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Clin Med 1 - Exam 4 > GI Bleeding > Flashcards

GI Bleeding Flashcards

1
Q

Bleeding is more common in which inflammatory bowel disease?

A

More common in UC than Crohns

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2
Q

Area of lower GI bleds

A

Distal to ligament of treitz

(jejunum to anus)

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3
Q

Three symptoms of anorectal abscess

A

Perianal pain

Fever

Bright red blood

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4
Q

Which condition is associated with “watermelon stomach”?

A

Gastric antral vascular ectasia

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5
Q

Which patients are most likely to have lower GI bleeds caused by angiodysplasia?

A

Elderly

Angiodysplasia = thin walled vessels, collagen degradation in elderly

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6
Q

Most common causes of peptic ulcer disease

A

US = NSAIDs

World = H. pylori

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7
Q

First test normally done in assessment of a GI bleed

A

Endoscopy

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8
Q

Most common cause of upper GI bleeds

A

Peptic ulcer disease

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9
Q

Three factors that make post-polypectomy bleeding more likely

A

Elderly

Polyp removed was larger than 1cm

Polyp was in cecum

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10
Q

Symptoms in diverticulosis caused by lower GI bleeds

A

Painless, large bloody stools

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11
Q

Diagnostic test of choice in an active GI bleed

A

CT angiography

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12
Q

Gold standard treatment for perianal abscess

A

Incision and drainage

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13
Q

Gold standard for diagnosis of peptic ulcer disease

A

EGD - endogastrodudodenoscopy

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14
Q

Location of Dieulafoy lesions

A

Upper stomach

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15
Q

Condition causing longitudinal lacerations of esophageal mucosa at gastrointestinal junction

A

Mallory-Weiss tears

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16
Q

Four risk factors for diverticulosis

A

Low fiber diet leading to constipation

NSAIDs/aspirin

Ischemic heart disease

Hypertension

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17
Q

Most common location of rectal fissures

A

Posterior anal canal

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18
Q

Treatment for proctitis

A

Steroid enemas

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19
Q

Name of procedure to shunt blood from portal vein to avoid the liver

A

TIPS

Trans-jugular intrahepatic portosystemic shunt

20
Q

This painful condition is referred to as a “stroke of the colon”

A

Ischemic colitis

21
Q

Rectal damage from radiation therapy can cause lower GI bleeds. This condition is known as …

A

Proctitis

22
Q

How long does bleeding show up after a polypectomy?

A

7-10 days

23
Q

Severe anal pain with passing of a bright red bloody stool in a patient with a history of constipation might suggest …

A

Rectal fissure

24
Q

CT angiography can only be used to diagnose these GI bleeds

A

Active GI bleeds

25
Q

Most common cause of occult GI bleeding

A

Inflammation

26
Q

Symptoms of proctitis

A

Lower GI bleed 9 months to a year after radiation therapy

27
Q

Symptoms in angiodysplasia caused lower GI bleeds

A

Intermittent, low grade bleeding

28
Q

Symptoms in variceal bleeds

A

Sudden overt bleeding

Large volume hematemesis

29
Q

Cause of Dieulafoy lesions

A

Large-caliber tortuous artery in stomach wall that erodes and bleeds

30
Q

Most common location for angiodysplasia in lower GI bleeds

A

Cecum or ascending colon

31
Q

Treatments for a hemodynamically unstable GI bleed

A

Large bore IV for fluid resuscitation with normal saline or lactated ringer

Transfusion for active, brisk bleeding
- Keep Hgb above 7

32
Q

Landmark used to distinguish upper from lower GI bleeds

A

Ligament of Treitz

33
Q

Bright red blood on the outside of stool is suggestive of

A

Hemorrhoids

34
Q

Cause of Mallory-Weiss tears

A

Retching/vomiting

Common in alcoholics

35
Q

Two common symptoms with upper GI bleeds

A

Melena

Hematemesis

36
Q

Medications for a GI bleed in a patient with a history of liver cirrohsis

A

IV ceftriaxone or ciprofloxacin

Octreotide to lower splanchnic blood flow and portal bp in varices

37
Q

Cause of Cameron lesions

A

Linear erosions due to hiatal hernia

38
Q

Describe “melena”

A

Black, tarry stool

39
Q

Cause of variceal bleeds

A

Dilation of small (distal) esophageal veins due to portal hypertension (alcoholism)

40
Q

Two most common causes of lower GI bleeds

A

Diverticulosis (most common)

Angiodysplasia

41
Q

Location of diverticulosis caused lower GI bleeds

A

Descending/left colon

42
Q

Treatment of variceal bleeds

A

Urgent IV fluids and transfusions

EG banding

Lower portal BP with non-selective beta-blocker

43
Q

Biggest risk factor for anorectal abscess

A

Diabetes

(also IBD, HTN, HIV, heme disorders)

44
Q

Reason for increased BUN/Cr in upper GI bleeds

A

From digestion of protein in red blood cells

45
Q

Signs in upper GI bleeds, in order

A

First sign: tachycardia

15% blood loss: orthostatic hypotension

40% blood loss: resting hypotension

46
Q

New iron deficiency anemia in a patient aged 50+ should be screened for this disease

A

Colorectal cancer

Clin Med 1 - Exam 4 (12 decks)

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