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Gasto > GI SS 3 > Flashcards

GI SS 3 Flashcards

1
Q

Acute LGIB with Rectal pain

A

External Hemorrhoids

Anal fissure

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2
Q

Occult GI bleed FOBT

A

POS FOBT without anemia equals colonoscopy

POS FOBT with anemia equals upper endoscopy and colonoscopy

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3
Q

Ligament of Treitz (2)

A

Muscle Suspends duodenum (Allows movement of intestinal contents) Anatomical Landmark Dividing Proximal the UGIB and Distal the LGIB

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4
Q

Black

A

Upper GI

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5
Q

Melena (quan)

A

dark tarry stool (As little as 50ml)

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6
Q

Acute Upper GI Bleeding Etiologies

A 
Peptic Ulcer Disease (PUD)
Portal Hypertension  Esophageal Varices (high mortality)
MalloryWeiss Tear
Vascular Anomalies
Gastric Neoplasm
Erosive Gastritis  associated with NSAID or Alcohol
Erosive Esophagitis  chronic GERD
Booerhave Syndrome
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7
Q

Acute LGIB Dx tests

A

1st Distinguish UP vs LOW GI Bleed

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8
Q

Acute Upper GI Bleeding presentation

A

Hematemesis
Melena
Rarely hematochezia (Req greater than 1L for UGIB)
Maybe associated with pain (Epigastric abdominal)

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9
Q

Acute LGIB with no pain

A

Internal hemorrhoids

Diverticular bleeding

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10
Q

Therapeutic colonoscopy

A

Vasoconstrictive injection cautery clipsorbands

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11
Q

Obscure GI Bleeding (3)

A

Unknown origin Upperorlower endoscopic eval equals MC from SML int

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12
Q

Acute LGIB with Abd painorcramps

A

IBD

Colitis

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13
Q

Hematochezia

A

Fresh blood passed into stool

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14
Q

Acute LGIB 2 Points

A

Majority bleeds from colon Lower risk of serious blood loss than UGIB

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15
Q

EGD

A

All patients with active Upper GI bleed

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16
Q

Occult GI bleed Lab tests (3)

A

Fecal Occult Blood Test
Fecal Immunochemical Test Only detects LGIB
CBC unexplained anemia

17
Q

High risk Patients for Acute UGIB (Admit where?)

A 
Age greater than 60
Comorbid illnesses
SBP less than 100 mmHg
Pulse greater than 100 bpm
Bright red blood in NG aspirate or upon rectal examination
Admit to ICU
18
Q

Acute Upper GI Bleeding DX features

A

Hematemesis
Varying degrees of hypovolemia
Pos or Neg Melena (may be hematochezia in massive bleed)

19
Q

Unstable Acute UGIB

A

IV
CBC PTorINR CMP type and screen
Fluid (isotonic fluids) or Blood Replacement (24 pRBC)
NG Tube Aspiration of blood or coffee ground material

20
Q

Acute LGIB with Large volume

A

Diverticular bleeding

21
Q

Assessment and stabilization of hemodynamic status UGIB

A

Stable vs Unstable Unstable SBP less than 100 (severe)

22
Q

Hematemesis

A

Vomiting blood

May be bright red or ‘coffeeground’ material

23
Q

Occult GI bleed (2)

A

No SandS May lose up to 100mlorday

24
Q

Surgery Acute LGIB

A

Last resort

Indicated if requires greater than 6 units of PRBC in 24 hrs or more than 10 units total

25
Q

Acute LGIB with Small volume

A

IBD has bloody diarrhea

Hemorrhoids has small drips into the toilet; blood when wiping; bloody streaks on stool

26
Q

Anorectal Diseases

A

Hemorrhoids fissures ulcers

27
Q

Acute UGIB Meds

A

IV or PO PPI IVOctreotide

28
Q

Acute LGIB Etiologies (less than50yo) ML’s

A

Anorectal Diseases
Inflammatory Bowel Disease
Infectious Colitis

29
Q

Octreotide

A

Decreases portal blood pressure (lowers rebleed risk)

30
Q

Acute LGIB Labs

A

CBC CMP

Anemia equals ominous sign for suspected neoplasm

31
Q

Maroon

A

Small intestine or right colonic source or

32
Q

Inflammatory Bowel Disease (2 types)

A

Ulcerative Colitis Crohn Disease

33
Q

Gastrointestinal Bleeding Types

A

Upper GI Bleeding Lower GI Bleeding Obscure GI Bleeding Occult Bleeding

34
Q

Acute LGIB Etiologies (greater than50yo) ML’s

A

Diverticulosis Lrg Volume painless bright red
Neoplasm
Angioectasias (greater than 70 yrs)
Ischemic Colitis

35
Q

Bright red blood color equals

A

Left colonic source

Hemorrhoids fissure diverticulitis IBD colitis

36
Q

Acute LGIB Treatments for LRG volume bleeding

A

Therapeutic colonoscopy
Intraarterial embolization
Surgery

37
Q

Acute LGIB Dx features

A

Hematochezia With or Without pain

Gasto (6 decks)

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