GI bleeds Flashcards
1
Q
What are the causes of acute lower GI bleeding?
A
Ischameic colitis Carcinoma of caecum Polyps Diverticular Crohn's, UC Haemorrhoids Anal fissure Solitary ulcer of recur Meckel's diverticulum
2
Q
What is the most commonest cause of chronic GI blood loss?
A
Hookworm
3
Q
What are rockall scores used for?
A
Score of 3+ indicates significant upper GI rebelled and mortality of 11%
4
Q
What are pre-endoscopy Rockall scores?
A
Age 60-79 = 1 point ≥80 = 2 points Shock Tachycardia ≥ 100 = 1 point SBP < 100 = 2 Co-morbidity Major = 2 points CKD/liver failure/ metastatic cancer = 3 points
5
Q
What are post endoscopy rockall scores?
A
Diagnosis 0 points for M-W Tear 1 for everything else 2 for malignancy Stigmata of bleeding Score 2 points if blood, a clot of spurting vessel seen
6
Q
What is the Glasgow-blatchford score?
A
Calculated pre-endoscopy Identify patients for whom outpatient care is suitable
>0 consider admission for endoscopy
6+indicates 50% change fo intervention being required
7
Q
Upper GI bleeding causes
A
Peptic ulceration (40%) Gastroduodenal erosions (15%) Oesophagitis (15%) Mallory-Weiss syndrome (15%): tears at gastroesophageal junction due to violent vomiting Varices (10%) Upper GI malignancy (1%)
8
Q
Upper GI bleeding symptoms
A
Haematemesis
Malaena (>50ml): blood altered by bacteria = tarry
Haematochezia: unaltered PR blood
Abdominal pain
Signs of underlying cause/shock
Chronic: signs/symptoms of iron deficiency anaemia
