Melena hematochezia occult GIB DSA Flashcards
How do occult GI bleeds present?
As signs of anemia (fatigue and SOB)
What are common causes of occult bleeding with iron deficiency?
1) Neoplasms
2) Angioectasia
3) IBD (CD more common)
In premenopausal women, iron deficiency anemia is most commonly attributable to?
Menstrual and pregnancy-associated iron loss
How are occult GI bleeds diagnosed?
1) Fecal occult blood test
2) Fecal immunochemical test
During an evaluation of occult bleeding, patients with iron deficiency anemia should be evaluated for what disease with either IgA anti-tissue transglutaminase or duodenal biopsy?
Celiac disease
It is recommended to pursue further evaluation of the small intestine for a source of obscure-occult bleeding in order to exclude?
Small intestinal neoplasm or IBD
What is the first thing you should think of when a patient over 45 presents with occult bleeding and iron deficiency anemia?
A patient over age 60 with a normal endoscopic evaluation and no other worrisome symptoms most commonly have blood loss from?
1) Colon cancer
2) Angioectasias
LGIB is defined as that arising below (distal) to?
Ligament of Treitz
10% of hematochezia is due to?
Upper gastrointestinal source
There is an increased risk of lower gastrointestinal bleeding in patients taking?
1) Aspirin
2) Non-aspirin antiplatelet agents
3) NSAIDs
Liquid medications with red dye, as well as certain foods, such as red Kool-aid™ and beets, can simulate?
Hematochezia
How are lower GI bleeds diagnosed in stable patients?
Colonoscopy
What saclike protrusions of the mucosa are the most common cause of major lower tract bleeding?
From what structure is it most common?
1) Diverticulosis
2) Sigmoid colon
How does diverticulosis present?
Acute, painless, large-volume bright red hematochezia in patients over age 50 years
Appendectomy for confirmed appendicitis (before age 20) has what effect on UC?
Antibiotic use within first year of life has what effect on IBD in childhood?
1) May protect against developing UC
2) Increased risk
A patient positive for serum anti-neutrophil cytoplasmic antibodies (ANCA) most likely has what condition?
A patient positive for Serum antibodies to Saccharomyces cerevisiae (ASCA) most likely has what condition?
1) UC
2) CD
What is seen on single contrast barium enema for CD due to narrowing from inflammation or stricture?
What is seen on single contrast barium enema for UC due to loss of haustra?
1) String sign
2) Lead pipe colon
Where does crohn’s disease cause pain?
How does the diarrhea present?
It causes acute ileitis which can mimic?
What further complications can it lead to?
1) Right lower quadrant pain
2) Usually without blood
3) Appendicitis
4) Abscesses, Strictures, and Fistulas
How does the diarrhea in ulcerative colitis present?
What common symptom does it cause?
Where does it cause the pain?
What unusual phenomenon can induce it?
1) Bloody diarrhea
2) Tenesmus/fecal urgency
3) LLQ pain
4) Recently quit smoking
Which IBD condition leads to toxic megacolon?
UC
Where does CD occur?
Where does UC occur?
1) Anywhere along GI tract and most common site is terminal ileum
2) Colon only and most common site is rectum