Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI/Liver > Lec 8 GI Bleed > Flashcards

Lec 8 GI Bleed Flashcards

1
Q

What does hematemesis suggest about location of bleed?

A

suggests upper GI blled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does coffee ground emesis suggest about location of bleed?

A

suggests upper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is melena?

A

thick black tarry stool containing blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does melena suggest about location of bleed?

A

almost always upper GI blled; but 10% from small bowel or proximal colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is hematochezia? what does it suggest about location of bleed?

A

bright red blood per rectum

usually due to lower GI bleed; or could indicate massive upper GI blled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What vital signs do you see in GI bleed?

A

hypotension and tachycardia from hypovolemia due to blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do you see on labs in GI bleed?

A
  • if acute: hematocrit % may not fall immediately b/c you lose whole blood
  • high BUN especially in upper GI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does high BUN suggest?

A

upper GI bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

WHen can you get false neg NG tube lavage? false positive?

A

false neg: tube coiled in stomach, bleed from duodenum

false pos: blood from trauma of passing the tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are common causes of upper GI bleed?

A
  • aspirin/NSAId –> peptic ulcer, gastritis, duodenitis
  • liver disease –> varices
  • preceding retching –> mallory weiss
  • GERD –> esophagitis
  • previous aortic aneurysm surgery –> aorto-enteric fistula
  • noeplasm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are signs of overt bleeding?

A

hematemesis, melena, hematochezia; red blood on toilet paper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are signs of occult bleeding?

A

microscopic blood in stool over wks to mos –> produces microcytic anemia and iron deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What constitutes upper GI?

A

duodenum and more proximal

aka proximal to ligament of trietz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are danger signs with peptic ulcer bleed?

A
  • shock
  • age > 60
  • comorbidities
  • melena + hematochezia
  • active bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is treatment for bleeding peptic ulcer?

A

IV fluid resuscitation

IV proton pump inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Are gastritis bleeds life threatening?

A

not usually

17
Q

Does neoplasia more commonly present as occult or overt bleed?

A

more commonly occult

18
Q

What is gastric antral vascular ectasia [GAVE]? another name?

A

called “watermelon stomach”
dilated mucosal vessels; more common in pts with renal problem or in elderly

cause of upper GI bleed

19
Q

What is a dieulafoy lesion?

A

large caliber artery entering mucosa –> causes significant bleed with small erosions; can start and stop

cause of upper GI bleed

20
Q

What are cameron lesions?

A

erosions or ulcerations that occur within a hiatal hernia

usually lead to iron deficiency anemia rather than hematemesis/melena

21
Q

What are most common causes of lower GI bleed?

A
  • hemorrhoid
  • fissure
  • colitis
  • polyp
22
Q

What do you see in bleeding hemorrhoid?

A

painless blood on tissue or in bowl

23
Q

What do you see w/ fissure clinically?

A

tearing/ripping as bowel movement passes anal canal

24
Q

What do you see with colitis clinically?

A

urgency, tenesmus, diarrhea, mucus

25
Q

What do you see when polyp causing GI bleed?

A

blood mixed with stool

26
Q

What are 2 acute causes of lower GI bleed?

A
  • diverticulosis

- arteriovenous malformations

27
Q

What are major causes of “obscure” GI bleeding?

A
  • small intestine: vascular, neoplastic [primary adenocarcinoma, lymphoma, metastatic disease], inflammatory [crohns], meckels
28
Q

What is nuclear scan for meckels

A
  • inject TC-99m which accumulates in gastric mucosa by binding parietal cells
    can see heterotopic gastric mucosa in most meckels
29
Q

What is advantage of double balloon enteroscopy?

A
  • can see the whole bowel and give therapy

- w/ capsule can see whole bowel but can’t treat

GI/Liver (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions