Upper GI Bleed Flashcards
1
Q
Where can an upper GI bleed come from?
A
- Oesophagus
- Stomach
- Duodenum
2
Q
What can cause an upper GI bleed?
A
- Varices
- Mallory-Weiss tear
- Ulcers
- Cancers
3
Q
How may bleeds present?
A
- Stained sputum
- Coffe-ground
- Haematemesis
- Melaena
4
Q
What score can grade an upper GI bleed?
A
Glasgow-Blatchford Score
5
Q
What are the parameters of a Glasgow-Blatchford Score?
A
- Drop in Hb
- Rise in Urea
- Hypotension
- Tachycardia
- Melaena
- Syncope
6
Q
What Glasgow-Blatchford Score indicates high risk?
A
Greater than 0
7
Q
What score can be used post-endoscopy?
A
Rockall Score
8
Q
How are Upper GI Bleeds treated?
A
ABATED
A-E approach Bloods Access (large bore cannulae) Transfuse Endoscopy (urgent 24 hours) Drugs (stop anti-coags and NSAIDs)
9
Q
What bloods should be done and why?
A
- FBC (anaemia, plat)
- UsEs (Urea)
- Coag (INR)
- LFTs (Varices)
- XMatch (2 units)
10
Q
What should you transfuse with in a big bleed?
A
Blood and FFP
11
Q
What can excess blood transfusion cause?
A
TRALI (Transfusion Related Lung Injury)
12
Q
How are varices treated?
A
- Terlipressin
- Prophylactic antibiotics
13
Q
What is the definitive treatment in an UGI bleed?
A
OGD and intervention
14
Q
What should be stopped prior to OGD?
A
PPI
