Upper & Lower GI Bleed

Question 1

MCC of Upper GI Bleed?

Answer 1

PUD (25%)

Question 2

Study of choice for upper GI bleed?

Answer 2

Endoscopy

Question 3

What anatomical landmark differentiates between an Upper and Lower GI bleed?

Answer 3

Ligament of Treitz

Question 4

Upper GI Bleed Trmnt?

Answer 4

Resuscitation
IV PPIs
Blood transfusion if Hb <7
Correct coagulopathies if HIGH INR or Platelets <50k

Question 5

Blood tranfusion is required if Hb is < _____

Answer 5

7

Question 6

Hematochezia

Answer 6

passage of fresh blood (red/marron) through the anus

Question 7

Is Hematochezia MC indicative of upper or lower GI bleed?

Answer 7

LOWER

Question 8

Is Melena usually indicative of upper or lower GI bleed?

Answer 8

UPPER

Question 9

What other med can cause black, melena like stools?

Answer 9

Pepto bismol (bismuth)

This is harmless.

Bismuth + sulphur in GI system = bismuth sulfide (black substance)

Question 10

Hematemesis

Answer 10

Question 11

MCC of lower GI bleed

Answer 11

Divertic

Hx: LLQ pain, +/- fever, older age

Question 12

Study of choice for lower GI bleed?

Answer 12

Angiography Dx & Therapeutic