UPPER GI BLEED

Question 1

HPI

Answer 1

Frequency and volume of vomit
Blood-streaked, coffee ground, or bloody vomitus
Frequency and volume of diarrhea
Bloody diarrhea
Constipation with blood streaked stool
Blood on toilet paper or blood in toilet bowl
Abdominal pain along with bloody vomitus or stool
Dyspepsia, heartburn, dysphagia
Fever

Question 2

Events leading up to

Answer 2

FB ingestion
Foreign travel
Sick contacts
Raw meat / poultry
Unpasteurized milk cheese, animal contacts, water source
Trauma to abdomen

Question 3

ROS

Answer 3

Skin: rashes
ENT: oral ulcers
MSK: joint pain
GI: perianal lesions
Constitutional: fever, weight loss, fatigue, failure to thrive, dehydration
Optho: ocular symptoms

Question 4

PMHx

Answer 4

GI disease
Liver disease
Abdominal surgery

Question 5

Medications

Answer 5

Iron, ASA, NSAIDS, steroids, alcohols, recent abx

Question 6

Common DDx: Child / Adolescent

Answer 6

Swallowed blood
Mallory-Weis tear
Gastritis
Esophagitis
PUD

Question 7

Uncommon DDx: Child / Adolescent

Answer 7

Esophageal Varices
Toxic / Caustic ingestion
Foreign body
Vasculitis
Bowel Obstruction
Crohn’s Disease
Coagulopathy
GI stromal tumors
Dieulafoy’s

Question 8

Workup: Labs

Answer 8

CBC
Type & Cross
Serum electrolytes
Renal function test
Liver function test
Coags
U/A
Stool C&S; O&P
C Diff

Question 9

Workup: Imaging

Answer 9

Ultrasound
CT
Endoscopy