Week 10 Clinical Investigation GI Bleed

Question 1

PUD is what and prevalence, cause/risk, mortality rate

Answer 1

1. Duodenal or gastric mucosa down to Muscularis
2. 20%-50% UGIB
3. H-pylori, NSAIDs, Alcohol, smoking , steroids
4. 7%, 80% resolve spontaneously

Question 2

SX that can point to PUD in a pt not showing signs of actual PUD

Answer 2

Dysphagia
Dyspepsia
Heartburn

Question 3

PUD TX

Answer 3

Over counte anti-acids, PPI, H2 blockers

Question 4

ABD pain location PUD

Answer 4

Epigastric or LUQ

Question 5

Imaging for PUD

Answer 5

CXR / AAS, CT if questionable bleed

EGD **

Question 6

Esophageal and gastric Varices mortality rate, and risk, and rate

Answer 6

1. 15%
2. Alcohol in US *, or anything causing portal HTN
3. 5%-20% UGIB

Question 7

Labs for variceal bleeding

Answer 7

1. High LFTs
2. High albumin
3. High ammonia
4. High INR (FFP can be given if severe)

Question 8

Imaging for Variceal bleeding

Answer 8

1. EGD **

2. CXR, AAS

Question 9

Variceal tx

Answer 9

1. IV AB (Rocephin = ceftriaxone) if from cirrhosis

2. Octreotide : somatostatin, Splanchnic vasoconstriction——> reduce portal HTN

Question 10

TIPS procedure

Answer 10

In ESLD and cirrhosis or to decrease portal HTN and Variceal hemorrhage and ASCITES
= create low-resistance channel from hepatic vein to intrahepatic part of portal vein