L9: GI blood loss

Question 1

most common place for GI bleeding

Answer 1

upper GI

Question 2

upper GI=

Answer 2

oesophagus
stomach
duodenum

Question 3

rarest place for GI bleeding

Answer 3

small bowel

Question 4

commonest cause of upper GI bleeding

Answer 4

peptic ulcer

Question 5

commonest causes of large bowel bleeding

Answer 5

angiodysplasia
diverticular disease
haemorrhoids

Question 6

effect of hiatus hernia

Answer 6

causes damage to inside of stomach from continuous movement

Question 7

mallory vice tear=

Answer 7

vomiting tearing the bottom of oesophagus

Question 8

what is higher pressure arterial or variceal bleed

Answer 8

arterial

Question 9

presentation of chronic GI bleeding

Answer 9

anaemia

positive FOB

Question 10

FOB=

Answer 10

faecal occult blood

Question 11

type of anaemia from GI bleed

Answer 11

iron deficiency

Question 12

presentation of acute GI bleeding

Answer 12

haematemesis
melaena
shock
pr bleed

Question 13

1st thing to do with acute bleeding

Answer 13

resuscitation

Question 14

aim to transfuse hb to

Answer 14

10g/dl

Question 15

aim for central venous pressure of

Answer 15

5-8cm JVP

Question 16

what is a good measure of whether the patient has sufficient blood

Answer 16

urine

Question 17

6 high risks for dying from bleed

Answer 17

age >65
co-morbidity 
-pulse >100bpm,
-Bp <100 
re-bleed in hospital 
-suspected variceal haemorrhage

Question 18

is alcoholism a high risk for dying from a bleed

Answer 18

no

Question 19

max score of high risk

Answer 19

11

Question 20

positives of endoscopy treatment

Answer 20

improves outcomes
stops people dying
reduces need for surgery
stops rebleeding

Question 21

ulcer high risk

Answer 21

active bleeding
visible vessel in ulcer base
adherent clot

Question 22

endoscopic treatment for bleeding ulcers

Answer 22

inject adrenaline

gold probe or other method

Question 23

when can you eat after endoscopy

Answer 23

4-6 hours after

Question 24

angiodysplasia=

Answer 24

small vascular malformaiton of the gut

Question 25

2 reasons for endoscopic therapy at colonoscopy

Answer 25

angiodysplasia

polyps

Question 26

factors suggesting a variceal bleed (5)

Answer 26

cirrhosis 
portal vein thrombosis 
jaundice 
splenomegaly 
ascites 
decreased albumin, urea, Na, platelets

Question 27

more up to date endoscopic management of varices

Answer 27

banding

Question 28

complications of management of varices

Answer 28

• bleeding
• ulceration, perforation or stricture
• embolisation of sclerosant