Haematemesis common blood findings

Question 1

Haematemesis macrocytic anaemia?

Answer 1

Consistent with alcohol consumption and vitamin B12 and folate deficiency, a patient with an acute bleed may still have normal Hb because there has been a proportional loss of plasma and haemoglobin.

Question 2

Haematemesis low albumin?

Answer 2

due to chronic liver failure, but maybe also malnutrition, malabsorption, nephrotic syndrome.

Question 3

Haematemesis raised liver enzymes ALT AST?

Answer 3

damage to hepatocytes, can be caused by alcohol abuse and cirrhosis

Question 4

Haematemesis raised bilirubin?

Answer 4

Explains the jaundice

Question 5

Haematemesis rasied GGT?

Answer 5

In the absence of changes to ALP, is consistent with alcohol abuse.

Question 6

Haematemesis prolonged clotting times

Answer 6

clotting factors are made by the liver so liver failure can lead to prolonged clotting times, this coagulopathy can lead to excessive bleeding from upper GI lesions.

Question 7

Haematemesis raised urea?

Answer 7

In the presence of normal renal function, an elevated urea reflects increased protein ingestion due to blood in the GI tract.

Question 8

Haematemesis viral hepatitis and HIV serology?

Answer 8

this is particularly important in patients with tattoos or IV drug users

Question 9

Haematemesis urinalysis

Answer 9

low albumin could be caused by proteinuria (resulting from nephrotic syndrome)