GI BLEEDING

Question 1

What is the purpose of the Blachford score? When is it taken?

Answer 1

To determine which patients need endoscopy

Question 2

What is the purpose of the Rockall score? When is it taken?

Answer 2

• To calculate mortality risk
• Before and after endoscopy

Question 3

How quickly should a patient with AUGIB be seen by an endoscopist? (assuming resuscitation is successful)

Answer 3

60 mins

Question 4

In addition to fluid resuscitation, what two medical therapies are indicated in a variceal bleed?

Answer 4

1. IV terlipressin 2mg QDS
2. IV ciprofloxacin + metronidazole

Question 5

In a non variceal bleed what medical therapy can be considered (this shouldn’t delay time to endoscopy)?

Answer 5

IV PPI

Question 6

What indicates major haemorrhage?

Answer 6

greater than 50% blood loss within 3 hours or blood loss rate of >150ml/m

Question 7

What further step shoud you take in the instance of major haemorrhage? What will this achieve?

Answer 7

Activate the major haemorrhge protocol

Will get O neg blood, FFP, plasma

Question 8

What should be your haemodynamic aims in a patient being transfused during AUGIB?

Answer 8

Aim for a Hb of 80g/L and systolic BP greater than 90mmHg providing patients are passing urine. Avoid over-transfusion of patients as this can lead to poor outcomes, particularly with variceal bleeds

Question 9

the gold standard imaging in acute diverticulitis is?

Answer 9

CT abdomen

Question 10

True or false: steroids play a crucial role in the management of acute diverticulitis?

In addition to steroids (or not) what else is indicated?

Answer 10

False

• fluids
• Abx
• Analgesia