GI bleeding COPY Flashcards
Common causes of bleeding: Upper GI
Gastritis/PUD, esophagitis
NSAID use/abuse
(Mallory-Weiss)
Common Cause of bleeding: lower GI
Hemorrhoids
Angiodysplasia (vascular malformations)
Diverticulitis
Colon cancer (>60 yo)
serious/scary causes of bleeding
Esophageal variceal rupture (portal HTN) Colon cancer (any age) Gastric cancer Inflammatory bowel disease (Crohn’s and ulcerative colitis) Diverticulitis Peptic ulcer disease
3 ways that bleeding can present
acute, subacute, occult
melena
black stool
“coffee ground” emesis is from what?
blood reacting with acid in the GI
hematochezia
bright red blood (from lower regions OR from a massive & acute upper GI bleed)
what is the “border” for upper vs lower GI regions
ligament of Treitz: ligament at upper/mid-duodenum
for evaluation of GI bleed, approach depends on _______, _______, and _______
severity of the GI bleed, most likely source, and patient-related factors (age, current meds, etc.)
endoscopy is the Dx procedure of choice because it can be ______ as well.
therapeutic
Acute GI bleed: make sure to assess ______ ________
hemodynamic stability !
variable types of anemia (usually Fe+ deficiency) can be indicative of acute or chronic GI bleed?
chronic
diarrhea can indicate GI bleeding, why?
blood is irritating to the GI system
general txt for upper/lower GI bleeds: acute vs chronic (weeds)
General treatment:
Acute– resuscitation, increase volume, RBCs, coags (FFP, PLT), NG lavage for decompression and assessment of continuing of bleeding
Chronic– D/C NSAIDs, treat H. pylori, acid suppression, control BP (varices)
Overall: acute- stabilize, chronic- txt the cause
bright red hematemesis in pts with liver disease, what is this from?
varices
THIS IS A HIGH RISK CRITERIA