Wk5 Lower GI bleeds

Question 1

2 most common causes of lower GI bleeds in adults:

Answer 1

1. Diverticular hemorrhage

2. Angiodysplasia

Question 2

Dx for Acute colonic diverticulitis:

Answer 2

CT

Question 3

Sx of acute diverticulitis:

Answer 3

Pain

Diarrhea

Fever

Abd tenderness

**hemorrhage is rare

Question 4

Surgical indication in diverticulitis:

Answer 4

perforation

Question 5

Tx for mild diverticulitis:

Answer 5

oral hydration

liquid diet

abx

Question 6

Age for acute diverticular hemorrhage

Answer 6

over 50

Question 7

Tx for acute diverticular bleed:

Answer 7

Resus

• reverse anticoag
• transfuse if necessary
• rule out upper GI bleed

Observe – 80% are self-limited

Question 8

Tortuous, dilated submucosal capillaries lacking smooth muscle

Answer 8

Angioectasia (Angiodysplasia)

Question 9

Most common cause of hematochezia in patients over 65:

Answer 9

Angioectasia

Question 10

Tx for angiodysplasia

Answer 10

Colonoscopy w/ablation

Question 11

Cause of non-occlusive ischemic colitis:

Answer 11

hypoperfusion

**also drugs, heart disease, exercise

Question 12

Cause of occlusive ischemic colitis:

Answer 12

embolic

a fib, thrombosis, hypercoag

Question 13

**Severe, ACUTE, abd pain followed by self-limited hematochezia:

Answer 13

Ischemic colitis

Question 14

Most common site for ischemic colitis:

Answer 14

Splenic flexure

Question 15

Management of ischemic colitis:

Answer 15

correct underlying cause (ie. reperfuse tissue)

Question 16

Occult slow bleeding, anemia

Answer 16

Neoplasm