GI Bleeding

Question 1

Most common location of an aorto-enteric fistula?

Answer 1

Third part of the duodenum

Question 2

Forest classification?

Answer 2

Active bleeding:
1A: arterial
1B: oozing

Recent bleeding:
2a: Visible vessel
2b: Adherent clot
2c: Flat pigmented spot

No bleeding
3: clean base

Question 3

Mechanism of gastric stress ulcers?

Answer 3

Mucosal hypoperfusion (minor role from acid)

Question 4

HVPG associated with treatment failure of a variceal bleed?

Answer 4

HVPG>20

Question 5

Endoscopic intervention that is technically better than balloon tapenade for refractory variceal bleeding?

Answer 5

Fully covered metal stent placement

Question 6

Preferred TIPS stent?

Answer 6

Polytetrafluoroethylene

Question 7

GOV1 vs GOV2?

Answer 7

Continuation of esophageal varices which extend:

Into the lesser curvature versus fundus

Question 8

IGV1 vs IGV2?

Answer 8

Isolated gastric varices in the fundus versus outside the fundus

Question 9

IGV2 varices are generally seen in these patients?

Answer 9

Non-cirrhotics with Splenic vein thrombosis

Question 10

BRTO versus BATO?

Answer 10

Balloon – occluded retrograde transvenous obliteration (through femoral vein, IVC, left renal)

Balloon-Occluded anterograde transvenous obliteration (through portal vein, splenic vein, gastric veins)

Question 11

Can avoid EGD for variceal screening if?

Answer 11

Elastography (liver stiffness) < 20kPa And platelets over 150

Question 12

Gastric bx shows dilated mucosal capillaries and spindle cell proliferation - Dx?

Answer 12

GAVE