GI Bleeds Flashcards

1
Q

four clinical presentations of upper GI bleeds - describe the location of where they would occur:

  1. haematemesis
  2. bleeding PR
  3. melena
  4. coffee ground vomiting
A
  1. fresh red blood vomiting from upper GI origin
  2. fresh red blood from lower GI origin
  3. digested blood from upper GI origin
  4. lower upper GI bleed - acted upon by stomach acid and been there for longer.
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2
Q

how much blood do you have to lose to be haemodynamically unstable?

how will this present in:

  • children
  • old and frail

what bpm and systolic BP?

A

500ml

  • children: just tachycardic as it takes a lot for them to be hypotensive
  • old and frail: tachycardic and low BP

> 100bpm + <100mmHg

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3
Q

if someone has stopped producing melena - have they stopped bleeding?

A

yes - as blood is a good laxative

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4
Q

what Ix would you do for a GI bleed?

what fluids would you give if they are haemodynamically unstable?

what is your next step if the patient is on anticoagulation?

A

FBC, U+E, LFT,
Group + Save

Hartmann’s

stop it and reverse it if on warfarin (give Vit k)

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5
Q

Why do you need to look at the urine output if they are a GI bleed patient?

whats a normal urine output?

A

to see if there is enough circulatory replacement ( will pass urine if they have enough fluid)

> 35ml/hour

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6
Q

Most common causes of UPPER GI bleeds?

if a 30 yr old w/ haematemesis
if a 70 yr old w/ haematemesis

A
  1. peptic ulcers (40%)
  2. gastritis (28%)
  3. oesophageal varices (14%)
  4. oesophagitis

= most likely oesophageal varices.
= most likely peptic ulcer.

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7
Q

Most common causes of LOWER GI Bleeds?

A
  1. Diverticular Disease (most common)
  2. Polyps
  3. Malignancy (mostly rectum)
  4. IBD
  5. Ischaemic colitis
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8
Q

Questions to ask for peptic ulcer:

A

Alcohol abuse
Smoking
H. pylori infection
NSAIDs

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