Occult GIB Flashcards
What is an Occult GI bleed?
Bleeding that is NOT apparent to the patient
not visible
What are the 2 most common causes of occult GI bleeding with Iron Deficient Anemia?
- Neoplasm
2. Vascular abnormalities (angioectasia/AVMs)
What are the 2 most common causes of occult GI bleeding with Iron Deficient Anemia?
- Neoplasm
2. Vascular abnormalities (angioectasias/AVMs)
In pre-menopausal women, is Iron Deficient Anemia normal?
Yes
In a person older than 45 with iron deficient anemia, what should you suspect?
Colon cancer
In a person older than 45 with iron deficient anemia, what should you suspect?
Colon cancer
What are the symptoms of an Occult GI bleed?
Iron Deficient Anemia in ABSENCE of visible blood loss
What are the symptoms of an Occult GI bleed?
Iron Deficient Anemia in ABSENCE of visible blood loss
In a patient with an Occult GI bleed, what should you evaluate for?
Celiac Disease
What tests will be (+) with an Occult GI bleed?
Fecal occult blood test
Fecal immunochemical test
What are 3 screenings for an Occult GI bleed?
Fecal occult blood test
Fecal Immunochemical test
Fecal DNA test
What can cause a false (+) for the fecal occult blood test?
Red meat, iron, aspirin, UGIB
What can cause a false (-) for the fecal occult blood test?
Vitamin C, intermittent bleeding
The Fecal Immunochemical test is sensitive to?
Hemoglobin
Which Occult GI bleed test is more sensitive to colorectal cancer and adenomas?
Fecal Immunochemical Test
Colon cancer usually occurs in those older than?
45
When should you start screening for Colon Cancer?
45
When should you start screening for Colon Cancer?
45
What do most Colon Cancers arise from?
Adenomatous polyps
There is high prevalence of colon cancer in patients with?
Streptococcus Bovis (gallolyticus) Bacteremia
There is high prevalence of colon cancer in patients with?
Streptococcus Bovis (gallolyticus) Bacteremia
Where does colon cancer usually metastasize?
Liver
Left sided colon cancer symptoms?
Change in bowel habits
Bleeding
Right sided colon cancer symptoms?
Anemia
Weight loss
Occult blood in stool
Bleeding and altered bowel habits may indicate colon cancer on the ___ side
LEFT
Anemia, weight loss and occult blood in stool may indicate colon cancer on the ____ side
RIGHT
What is the gold standard for detecting colon cancer?
Colonoscopy
What does a Barium enema show with colon cancer?
Apple core sign
In those with Arteriovenous Malformations (AVMs)/Angioectasias, what may be history items?
Occult GI bleed Painless bleeding (melena, hematochezia)
Arteriovenous Malformations (AVMs)/Angioectasias are common in patients with what conditions?
Renal failure
Aortic Stenosis
What are the symptoms of Arteriovenous Malformations (AVMs)/Angioectasia?
Iron deficient anemia with NO cause
Patients older than 60 with Occult GI bleed and a normal endoscopic evaluation you should consider?
Angioectasias/AVMs
Patients older than 60 with Occult GI bleed and normal endoscopic evaluation you should consider?
Angioectasias/AVMs
Occult GI bleed with normal endoscopic evaluation?
Angioectasias/AVMs
Unintentional weight loss
Loss of 5-10% of body weight over 6 months
Patients with unintentional weight loss should get what things done during a physical exam?
Weigh them
Fecal Occult Blood Test
Screen for depression
Males with unintentional weight loss should get what exams?
Prostate and rectal exam
Females with unintentional weight loss should get what exams?
Pelvic
Patients with unintentional weight loss should get what things done during a physical exam?
Weigh them
Fecal Occult Blood Test
Screen for depression
