Oesophageal Bleeding

Question 1

What is a Mallory-Weiss tear?

Answer 1

Tear at the gastro-oesophageal junction due to periods of retching

Question 2

What is the main cause of a Mallory-Weiss tear?

Answer 2

Periods of Heavy drinking

Question 3

What does a Mallory-Weiss tear result in?

Answer 3

Large volumes of bright red blood

Question 4

What can a Mallory-Weiss tear result in?

Answer 4

Haematemesis

Question 5

How does a Mallory-Weiss tear resolve?

Answer 5

By itself

Question 6

What are oesophageal varices?

Answer 6

Dilated oeosphageal veins

Question 7

What are oesophageal varices due to?

Answer 7

Severe liver disease

Question 8

What are oesophageal varices secondary to?

Answer 8

Cirrhosis

Question 9

How do oesophageal varices present?

Answer 9

Large volumes of dark red blood

Question 10

What are oesophageal varices a common cause of cause in patients with cirrhosis?

Answer 10

Mortality

Question 11

What do people with oesophageal varices have a history of?

Answer 11

Liver disease

Question 12

What is the bleeding in oesophageal varices due to?

Answer 12

Fragile veins are more likely to bleed due to portal hypertension

Question 13

What symptoms present along with the large volumes of dark red blood?

Answer 13

Physical signs of portal hypertension

Painless and sudden onset

Question 14

How are oesophageal varices diagnosed?

Answer 14

Endoscopy

Question 15

What is the immediate management of oesophageal varices?

Answer 15

Blood transfusion

Vasopressin analogue

Question 16

What is an example of a vasopressin analogue?

Answer 16

Terlipressin

Question 17

What would you do if the bleeding with oesophageal varices was uncontrollable?

Answer 17

Sengstaken-blakemore tube

Question 18

What is the management of oesophageal varices when the patient is haemodynamically stable?

Answer 18

Variceal band ligation

Question 19

What would you give prophylactically to prevent oesophageal variceal bleeding?

Answer 19

Propranolol

Question 20

What medication can you give for oesophageal varcies while the patient is awaiting endoscopy?

Answer 20

Terlipressin

Question 21

What can be done if all other interventions aren’t successful at preventing another episode for oesophageal varcies?

Answer 21

TIPSS

Question 22

What is a complication of TIPSS?

Answer 22

Can exaccerbate hepatic encephalopathy (confusion)

Question 23

When might you give prophylactic antibiotics to someone with oesophageal varcies?

Answer 23

Present with cirrhosis and upper GI bleeding

Question 24

What prophylactic antibiotic would you consider giving for coesophageal varcies?

Answer 24

Quinolones