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gi bleeding Flashcards

1
Q

what is haematemesis

A

vomiting of blood

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2
Q

what is melaena

A

passage of black tarry stools

black is due to blood altered by passage through the gut

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3
Q

what is passage of dark blood and clots without shock due to

A

lower GI bedding

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4
Q

what is most common cause of serious and life threatening GI bleeding

A

peptic ulcer

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5
Q

what can cause significant GI bleeding in developing world

A

viral infections

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6
Q

what are causes of upper GI bleeding

A
  • mallory-weiss syndrome
  • gastric ulcer
  • duodenal ulcer
  • varices
  • gastric varices
  • gastric carcinoma
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7
Q

what drugs can produce ulcers

A
  • aspirin

- NSAIDs

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8
Q

what scoring is based clinical and endoscopy findings

A

Rockall score

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9
Q

what scoring is based on plasma urea, haemoglobin and clinical markers

A

Blatchford score

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10
Q

what is immediate management

A

stop:

  • NSAIDs
  • aspirin
  • clopidogrel
  • warfarin

stopping anti-platelets can. be dangerous and may produce thrombosis

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11
Q

what is done to diagnose

A

endoscopy

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12
Q

how are varices treated

A

banding

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13
Q

what else is used for bleeding varices

A

stenting

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14
Q

treatment for bleeding ulcers

A
  • injection with adrenaline
  • endoscopic clipping
  • inject thermal coagulation

select 2/3

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15
Q

what should be done

A

antral biopsies to look for H.pylori

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16
Q

what should be done first for treatment after endoscopy

A

IV PPI

because it reduces bleeding rates and need for surgery

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17
Q

what is mallory-weiss tear

A

linear mucosal tear occurring in oesophagogastric junction

18
Q

what does mallory-weiss tear often follow

A

bought of coughing or retching

commonly seen after alcoholic ‘dry heaves’

19
Q

treatment for mallory-weiss tear if any

A

clipping

surgery with oversewing if tear is really bad but rarely

20
Q

treatment if patient has chronic peptic ulcer

A

eradication of H.pylori

21
Q

what is continued if patient has chronic peptic ulcer and for how long

A

PPI for 4 weeks to ensure ulcer healing

22
Q

what is done if bleeding is not under control in patient with peptic ulcer

A

angiography and embolisation
or
surgery

23
Q

what is massive bleeding from lower GI tract due to

A

diverticular disease
or
ischaemic colitis

24
Q

what are common cause of small bleeds

A

haemorrhoids

anal fissure

25
Q

other causes of lower GI bleeds

A
  • angiodysplasia
  • carcinoma
  • diverticula
  • meckel’s diverticulum
  • anal fissure
  • colitis
  • haemorrhoids
  • polyps
  • ischaemic colitis
26
Q

do lower GI bleeds usually stop spontaneously

A

yes

27
Q

how is diagnosis of lower GI bleed usually done

A

history and examination (rectal exam)

28
Q

what investigations are done for lower GI bleeds

A
  • proctoscopy
  • flexible sigmoidoscopy
  • video capsule endoscopy
  • angiography
29
Q

what is proctoscopy good for

A

haemorrhoids

30
Q

what is sigmoidoscopy good for

A

IBD
cancer
ischaemic colitis
diverticular disease

31
Q

what do patients with chronic GI bleeding have with it

A

anaemia

32
Q

what is primary concern of GI bleeding in adults

A

cancer
of stomach, right colon

and coeliac disease

33
Q

what is most common cause of chronic GI blood loss

A

hookworm

uncommon in developed world

34
Q

what is usually performed first in chronic GI bleeding

A

upper GI endoscopy

35
Q

what should be done during endoscopy for chronic GI bleeding

A

biopsy

to diagnose coeliac disease

36
Q

what is done second in chronic GI bleeding

A

colonoscopy

37
Q

what is useful diagnosis for colon cancer in frail patients

A

CT

38
Q

what is an alternative to colonoscopy

A

CT colonography

39
Q

what is diagnostic investigation of choice for upper GI bleeding

A

capsule endoscopy

40
Q

what is given to treat anaemia

A

oral iron

GI (50 decks)

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