git bleeding

Question 1

upper git boundary?

Answer 1

mouth to 2nd part of doudenum above ligament trietz

Question 2

symptoms of upper git bleeding?

Answer 2

hematemesis, melena( black tarry stool)mostly in ugib, weakness, syncope, anemia, sweating, cold peripheri,

Question 3

signs of upper git bleeding?

Answer 3

sweating, rapid pulse more than 100, low bp 90/70, oliguria,

Question 4

causes of upper git bleeding?

Answer 4

most common peptic ulcer, gastritis, gastric cancer, varcies, esophagitis, mallory weiss tear( forcefull vomitng before hematomasis), divertoculosis in uk most common cause, gastric erosion(nsaids, alcohol), vascular malformation

Question 5

rockall score for risk in acute upper git bleeding?

Answer 5

score range 0-11 <3 good prognosis >8 bad prognosis

Question 6

management?

Answer 6

1,iv access with large bore cannula
2,basic investigation(blood cp, urinary analysis, electrolytes, lft, pt ,
3,resuscitation by iv colloids fluid replacement
4, oxygen
5,endoscopy with ppi to prevent rebleeding in peptic ulcers, vasopressin for variceal bleeding
6, monitoring
7, surgery for bleeding lesion
transfusion need: haemoglobin less than 10mg and hematocrit less than 30

Question 7

boundary of lower git?

Answer 7

2nd part of doudenum to rectum

Question 8

most common cause of severe acute lower git bleeding?

Answer 8

diverticulosis treatment( endoscopy thermal ablation)

Question 9

most common cause of chronic and subacute lower git bleeding?

Answer 9

haemorrhoids and anal fissure

carcinoma

Question 10

what will done if endoscopy and colonoscopy fails to diagnosis site of bleeding?

Answer 10

mesenteric angiography in massive non responsive bleeding,

Question 11

most common cause of occult feacal bleeding?

Answer 11

colorectal cancer, stool test to detect blood is not important because tumors bleed intermittently