21. Rectal Bleeding Flashcards Preview

YR3: MM FC Ed. > 21. Rectal Bleeding > Flashcards

Flashcards in 21. Rectal Bleeding Deck (21)
Loading flashcards...
1

What 4 categories can you classify the causes of rectal bleeding into?

Anorectal
Colonic
Ileo Jejunal
Upper GI

2

What are 7 anorectal causes of rectal bleeding?

Haemorrhoids
Rectal/ anal tumour
Anal fissure/ fistula
Rectal ulcer
Radiation proctitis
Rectal varices
Trauma

3

What are 6 colonic causes of rectal bleeding?

Diverticular disease
Angiodysplasia
Colitis
Colonic tumour
Iatrogenic: biopsy, anastamotic leak
Vasculitis

4

What are 7 ileo jejunal causes of rectal bleeding?

(these are less common)
Peptic ulcer
Angiodysplasia
AV malformation
Crohn's disease
Coeliac
Aort-enteric fistula
Small bowel tumours

5

What are 8 upper GI causes of rectal bleeding?

Peptic ulcer
Gastritis
Varices
Tumours
MW tear
Osler Weber Rendu syndrome
Aorto enteric fistula
Dieulafoy lesion

6

What will you ask about in the presenting complain of someone with diarrhoea?

Amount
Duration + frequency
Colour of blood
Relationship of blood with stool
Pain or prolapse on opening the bowels
Tenesmus
Changes in bowel habit
Weight loss
Anaemia symptoms

7

What does blood mixed with the stool suggest?

Lesion proximal to sigmoid colon

8

What does blood streaked on stool suggest?

Source is sigmoid or anorectal

9

What does blood separate from the stool suggest?

Haemorrhoids
If blood on its own- diverticular disease
Angiodysplasia
IBD
Cancer

10

What does blood on the toilet paper suggest?

Minor bleeding from anal canal- haemorrhoids or anal fissure

11

Which causes of rectal bleeding are painful?

Colitis (abdo pain)
Anal tumour/ fissure

12

What should you ask in the PMHx of someone with diarrhoea?

Previous rectal bleeding
UC
Bowel trauma
Bleeding tendency
Aortic surgery
Radiotherapy to rectum

13

What imaging should be done in someone with a rectal bleed?

Proctoscopy +/- endocopy unless it is a very painful lesion (anal fissure)

14

Which drugs increase the risk of bleeding?

Anticoagulants
Antiplatelets
NSAIDs

15

Which drugs increase the risk of peptic ulcers?

NSAIDs
Steroids
Bisphosphonates

16

Which drugs increase risk of infective colitis?

Antibiotics
PPIs

17

Which drugs cause an attenuated response to hypovolaemia?

B blockers

18

What is ferritin? What may cause it to rise?

Acute phase protein
Infection
Inflammation
Malignancy
Excess alcohol

19

What is the ferritin, TIBC and CRP in iron deficiency anaemia?

Ferritin: Low
TIBC: High
CRP: Normal

20

What is the ferritin, TIBC and CRP in anaemia of chronic disease?

Ferritin: High
TIBC: Low
CRP: Normal or high

21

What is the ferritin, TIBC and CRP in iron deficiency anaemia with infection/ inflammation?

Ferritin: High
TIBC: High
CRP: High