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Gastro 2 > GI Hemorrhage > Flashcards

GI Hemorrhage Flashcards

1
Q

Melena indicates blood in GI tract for

area of stomach supplied

Gastric artery

Gastroduodenal artery

A

14 hrs

Anterior and lesser

Posterior, greater curvature

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2
Q

Ulcer appearance and Mx

Low risk

High risk

A

L- flat/pigmented/clean base
Oral PPI

H- w clot/nonbleeding vessel/active bleeding
Endoscopic hemostasis/observation/IV PPI

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3
Q

Common Upper GI bleeding

E_____ g_____
D____/G____ u

D______
E______

A 
Erosive gastritis- alcohol/NSAID
Duodenal/gastric ulcer- (aspirin/NSAID/PUD)
Esophageal varices- cirrhosis
MW
Duodenitis (alcohol/NSAID)
Esophagitis (GERD/Heartburn/Rad)
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4
Q

Common Lower GI bleeding

D\_\_\_\_\_
I\_\_\_\_
N\_\_\_\_\_
Ang\_\_\_\_\_\_
\_\_\_\_/\_\_\_\_\_
A 
Diverticulusis
Ischemia (Afib/HypoTN)
Neoplasia
Angiodysplasia
IBD/Colitis
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5
Q

Diverticular bleeding usually from

Most stop

Mx for persistent bleeding

A

r side

spontaneously

endoscopy/subtotal colectomy

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6
Q

Management of bloody vomit

Volume resus

Intravenous

Endoscopic hemostasis

A 
IV crystalloid (NS/Ringers)
Packed RBC if hb<7

PPI

manage high risk lesions, reduce risk

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7
Q

Esophageal varices difference from normal bleeding

Management

A

less likely to stop spontaneously

IV Fluids/albumin
Octreotide
PPI
AB for SBP

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8
Q

Variceal management first line

Endoscopic hemostasis

Prevention/tx cirrhosis

A

vasopressin/somatostatin- VC splanchnic/dec portal BF

Banding

AB for SBP, IV Fluids/albumin
Nonselective BB (Nadolol/propanolol to 55/60 bpm)
Band ligation

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9
Q

HHT (OWRS)

AVM location

A

cutaneous

GI

Pulmonary

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10
Q

Aortoenteric fistula

Direct comm between aorta and GI tract

MC location

Presentation

Mx

A

Complicated aortic graft/aneurysm/therapy

Distal duodenum

Herald bleed- hematemesis/hematochezia
Massive bleeding
Back/ab pain

Surgery

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11
Q

Tx for hemorrhoids

Meckel diverticulum

pop

where

length

A

Hydrocortisone/topical analgesia
Surgery if recurrent

males

2 feet of ICV

2 inches long

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12
Q

MD development

CM

Dx

A

vitelline/omphalomesenteric duct should be obliterated in 5-7th wks

Asx
Bleeding (ileal ulceration)
IO (volvulus/intussception)
Diverticulitis

RN scans for ectopic gastric mucosa
Mesenteric angiography

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13
Q

Use of RN imaging
blood loss

Angiography
Blood loss

indicated for

A

plan for surgery/angiography
150

must localize to major vessel
750

massive obscure bleeding- no hemostasis/unstable

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14
Q

Etiology of Occult blood loss

A 
CC
Esophagitis
PUD
Gastritis
IBD
Celiac 
Small bowel tumors
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15
Q

Colorectal carcinoma

CM

Bright red blood per rectum

maroon/melena/occult blood

Dx

A

low grade occult blood

distal colon

proximal colon

colonoscopy w biopsy

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Gastro 2 (28 decks)

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