L20 - GI Bleed

Question 1

75-80% of all GI bleeding are what?

Answer 1

UGIB

Question 2

90% of the time melena is secondary to what?

Answer 2

UGIB

Question 3

Hematochezia is usually due to what?

Answer 3

LGIB

Question 4

What are the MCC of UGIB?

Answer 4

PUD and esophageal varices

Question 5

What are the MCC of LGIB?

Answer 5

Diverticulosis

Anorectal dz, ischemic colitis, colon cancer

Question 6

What is the gold standard for imaging when concerned for a GI bleed?

Answer 6

Endoscopy

EGD for UGIB and colonoscopy for LGIB

Question 7

Transfusions are recommended at what hemoglobin value even without active bleeding?

Answer 7

<7

Question 8

What are risk factors for PUD?

Answer 8

H pylori, NSAIDs, smoking, EtOH, glucocorticoids (steroids)

Question 9

What is the gold standard for PUD diagnostic testing?

Answer 9

EGD

Both diagnostic and therapeutic

Question 10

What is the gold standard for diagnostic testing in pts with variceal bleeding?

Answer 10

EGD

Question 11

Pts with colonic diverticula bleeding typically present with what?

Answer 11

Painless hematochezia that is self limited

50% of pts have had a previous episode of hematochezia

Question 12

What are the sx for acute colonic ischemia?

Answer 12

Rapid onset of mild cramping abdominal pain and tenderness over the affected bowel most often involving the left abdomen
Pt doesnt appear severely ill
Rectal bleeding or bloody diarrhea often present

Question 13

What are the sx for chronic colonic ischemia?

Answer 13

Recurrent abdominal pain, bloody diarrhea, weight loss from protein losing enteropathy,, recurrent bacteremia, persistent sepsis, or symptomatic colonic strictures

Question 14

Which lab test should be preformed for ischemic colitis?

Answer 14

D dimer

Question 15

What is the diagnostic test of choice for ischemic colitis?

Answer 15

Colonoscopy/sigmoidoscopy

Question 16

What is the MC source of slow occult lower GI blood loss?

Answer 16

Colon cancer