OnlineMedEd: Intern Content - "GI Bleed"

Question 1

Review the causes of UGIB.

Answer 1

• Epistaxis
• Oropharyngeal trauma
• Esophagitis
• Esophageal varices
• Esophageal cancer
• Ulcer
• Gastritis/gastropathy
• Gastric malignancy
• Dieulafoy malformation
• AVM

Question 2

Review the causes of LGIB.

Answer 2

• AVM
• Colon cancer
• Diverticuli
• Polyps
• Hemorrhoids

Question 3

At what dose do you give PPIs in a GI bleed?

Answer 3

• 80 mg IV initially

* 8 mg/hr over the next hours

Question 4

For every ________ units of pRBCs, you need to give one unit of FFP.

Answer 4

3

Question 5

Once again, review the initial treatment for GIB.

Answer 5

• Two large-bore IVs
• Type and cross
• IV bolus
• IV PPis

•Octreotide if cirrhotic

Question 6

NG lavage has poor ______________.

Answer 6

sensitivity; up to 1/3 of those with UGIB are negative on NG lavage

Question 7

Tagged RBC scans are sensitive to what rate of hemorrhage?

Answer 7

~ 20 mL/hr or ~ 500 mL/day

Question 8

Which areas of the GI tract are not accessible by endoscopy?

Answer 8

Distal duodenum to ileocecal valve