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First Aid & Emergency Medicine > GI bleeding > Flashcards

GI bleeding Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

What is upper go bleeding defined as?

A

Hemorrhage any any source between the pharynx and the ligament of Treitz (duodenal-jejunal junction)

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2
Q

Are upper or lower GI bleeds more common in the ER?

A

Upper - 75 % of patients presenting to ER with GI have an upper source

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3
Q

What is the DDX of an upper GI bleed?

A 
PUD (50%)
esophageal varices
Mallory- Weiss tear
esophageal rupture
Boerhaave's syndrome
bleeding gastric varices
Angiodysplasia
Cancer
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4
Q

What is angiodysplaysia?

A

Arteriovenous malformations located in the cecum and ascending colon.

Where an artery and vein come together without the architecture of the capillaries:

high pressure arteries meet low pressure veins without the buffering of capillaries

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5
Q

A patient with liver cirrhosis with an upper GI bleed is most likely to have was dx?

A

rupture of esophageal varies.

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6
Q

What is the mainstay of urgent treatment of ruptures esophageal varies?

A

Therapeutic endoscopy ->then banding, scleropathy or ballooning

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7
Q

What is a mallory- weiss tear and where is it located?

A

Partial thickness tear located at the esophageal- gastric junction

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8
Q

What is Boerhaave’s syndrome and where is it located?

A

Full thickness tear located anywhere along the esophagus

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9
Q

What is hematemesis?

A

Bright red blood in the vomit

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10
Q

What is coffee ground vomit

A

blood that has been sitting in the stomach long enough to have HCl break it down.

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11
Q

What is melena?

A

partially digested blood in the stool?

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12
Q

What is hematochezia?

A

fresh blood in the stool (can have a maroon color)

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13
Q

What is the order to things to do during emergency evaluation of upper GI bleed?

A
  1. Visualization
  2. Treatment
  3. Biopsy
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14
Q

For an upper GI bleed what is the first choice treatment option?

A

Upper endoscopy

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15
Q

What parameters are checked in the Glasgow-Blatchford Scale?

A
  1. Hemoglobin (different for men and women)
  2. Systolic blood pressure
  3. Pulse
  4. Serum BUN
  5. melena or syncope
  6. Past or present history of liver disease or congestive heart failure
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16
Q

What is the Glascow- Blatchford Scale use for?

A

The likelihood that a patient with an acute upper gastrointestinal bleeding (UGIB) will need to have medical intervention such as a blood transfusion or endoscopic intervention.

17
Q

True or false: Death in those patients with a GI bleed is
more commonly due to other illnesses
(some of which may have contributed to
the bleed, such as cancer or cirrhosis), than
the bleeding itself.

A

True

18
Q

What is the definition of a lower GI bleed?

A

A bleed that
occurs distal to the ligament of Treitz.
• This includes the last 1/4 of the duodenum and the entire area of the jejunum, ileum, colon, rectum, and anus.

19
Q

What side of the colon is there a bleed with maroon stool?

A

Right

20
Q

What side of the colon is there a bleed with bright red blood in stool?

A

Left

21
Q

Diverticula ar most common in what portion of the colon?

A

Sigmoid and descending

22
Q

What is more common” - UC or Crohn’s Dz?

A

UC

23
Q

What is the standard of care for diagnosis and often therapeutic intervention of Lower GI bleeds?

A

Colonoscopy

24
Q

What is performed is colonoscopy has failed to identify the bleeding site?

A

Angiography

25
Q

What are the three major components to managing LGIB?

A

1) resuscitation and initial assessment
2) localization the bleeding site
3) therapeutic intervention to stop bleeding at the site

26
Q

A score of __ or more is associated with a greater than 50% risk of significant bleeding that require urgent/emergent intervention on the Glascow-Blatchford scale.

A

6

27
Q

What is the purpose go the Rockall scale?

A

The scale attempts to identify patients at risk of DEATH following acute UPPER GI Bleeding.

28
Q

What procedure is required for the Rockall scale?

A

Upper endoscopy

29
Q

What parameters does the rockall scale look at?

A 
A - age
B - blood pressure fall (shock)
C- Co-morbitidy
D - Diagnosis (of GI condition)
E - Evidence of bleeding.
30
Q

In the Rockall Scale a score more than __ caries high risk of mortality. A score less than __ carries a good prognosis.

A

8, 3

First Aid & Emergency Medicine (10 decks)

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