GI bleeding and emergencies CIS

Question 1

most common place for H pylori

Answer 1

duodenum

Question 2

on endoscopy- inc chance of rebleeding?

Answer 2

red wale markings

Question 3

clinical predictors of inc risk of rebleeding

Answer 3

• > 60 yo
• comorbid illness
• SBP < 100
• HR > 100
• bright red blood in NG aspirate or on rectal exam

Question 4

portal HTN/varices- inc risk of bleeding

Answer 4

• size of varices
• red wale markings
• liver dz severity
• acive alcohol abuse

Question 5

treatment for esophageal varices

Answer 5

• variceal banding

- balloon tamponade

Question 6

UGIB- where?

Answer 6

proximal to ligament of treitz

Question 7

UGIB- causes

Answer 7

• PUD
• portal HTN- esophageal varices- mortality at 80% with recurrent bleeding!!
• mallory-weiss tears

Question 8

UGIB- tx

Answer 8

-2 18 gauge or larger IV lines!!

Question 9

assoc with angiodysplasia/vascular ectasia?

Answer 9

-chronic kidney disease

Question 10

LGIB- caused by- < 50 yo

Answer 10

-infectious colitis, anorectal dz, IBD

Question 11

LGIB- caused by- > 50 yo

Answer 11

• diverticulosis- most common cause of major LGIB!!- painless
• angioectasias
• neoplasms
• IBD
• ischemic colitis- crampy abd pain

Question 12

LGIB- diagnostics

Answer 12

colonoscopy

• bowel prep- if hemodynamically stable and w/o active bleeding
• urgent- if hemodynamically unstable and w/ active bleeding

Question 13

if small bowel obstruction- use what to relieve sx?

Answer 13

-nasogastric tube to suction

Question 14

family mediterranean fever- in who? tx?

Answer 14

• lack of protease in serosal fluids
• < 20 yo
• episodic bouts of acute peritonitis- abd pain, fever
• self-limiting (colchicine can help)

Question 15

toxic megacolon

Answer 15

• complication of IBD and C diff!!!
• high risk of perforation
• tx- surgery