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Alimentary System: Pathology SA > Acute Gastrointestinal Bleeding: Upper GI bleeding > Flashcards

Acute Gastrointestinal Bleeding: Upper GI bleeding Flashcards

1
Q

Where does Upper Gi Bleeding originate from

A

Oesophagus
Stomach
Duodenum

(Proximal to ligament trietz)

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2
Q

Where does Lower GI bleeding originate from

A

Bleeding distal to duodenum

(distal ligament of Treietz

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3
Q

What is the presentation of Upper GI bleeding

A

Haematemesis

Melaena

Elevated Urea

dyspepsia, reflux,
epigastric pain

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4
Q

What GI bleeding is associated with NSAIDS

A

Upper GI bleeding

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5
Q

What GI bleed is more common in older age

A

Lower GI bleeding

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6
Q

What is the presentation of lower GI bleeding

A

Fresh blood/clots

Magenta stools

Normal urea

Typically painless

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7
Q

What are two problems that after all areas of upper GI tract causing GI bleeding

A

Ulcers

Oesophagitis/duodenaitis/gastritis

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8
Q

What are 4 causes of Upper GI bleeding in the oesophagus

A

Oesophageal varices

Mallory Weiss Tear

Oesophageal malignancy

Ulcer

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9
Q

What are the 5 causes of Upper GI bleeding in the stomach

A

Gastric varices

Gastric malignancy (may be under an ulcer)

Dieulafoy

Angiodysplasia

Lymphoma of the stomach

Ulcer

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10
Q

What is the 2 causes of upper Gi bleed from the duodenum

A

Angiodysplasia

Ulcer

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11
Q

What is the most common cause of GI bleed

A

Peptic ulcer

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12
Q

What is the aetiology of peptic ulcer

A 
Liver disease
Drugs - NSAIDS
Alcohol 
Smoking 
H.Pylor 
Systemic - stress ulcers
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13
Q

What is the pathology of a peptic ulcer

A

Increase damage or impaired defences results in

Necrosis debris,
Non specific acute inflammation
granulation tissue and fibrosis

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14
Q

What is the pathology of H.Pylori result causing a peptic ulcer

A

produces enzyme urease, which breakdown product ammonia causes a buffer of gastric acid, therefore increasing acid production

Increasing the damage to the surface

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15
Q

What is the pathology of NSAIDS/Aspirin causing a peptic ulcer

A

Prostaglandin production reduced mucus and bicarbonate excretion therefore reducing physical defence

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16
Q

What is Zollinger - Ellison syndrome and its affect on peptic ulcers

A

gastrin-secreting pancreatic tumour

that result in recurrent poor healing duodenal ulcers

17
Q

What can gastric ulcers potentially cover

A

Gastric carcinoma

18
Q

What is the causes of gastritis and duodentits

A

Due to impaired coagulation:
Medical condition
Anti-coagulants
Anti-Platlets

19
Q

What is the causes of oesophagitis

A

Reflux oesophagitis

Hiatus hernia

Alcohol

Bisphosphonates

Systemic illness

20
Q

What anti-platelet medication may give you significant bleeding

A

Clopidogrel

Ticagrelor

21
Q

What anti-coagulation medication may give you significant bleeding

A

warfarin, rivaroxaban, apixaban, dabigatran

22
Q

What is the pathology of varices

A

LIver cirrhosis results in portal hypertension ,

The increased portal pressure, abnormally dilate collateral vessels and lead to life threatening bleeding

23
Q

Where is the 3 locations of varices can occur in the GI tract

A

Oesophagus

Gastric renal and splenic

24
Q

What is the symptoms of oesophageal cancer

A

Dysphagia
Weightloss
“ooze”

25
Q

What can gastric cancer present as

A

A gastric ulcer sitting on top

26
Q

What is the pathology and symptoms of Mallor weir tear

A

Linear tear at the oesophageal-gastric junction

Follows period of retching and vomiting

27
Q

What is the pathology of dieulafoy

A

Located in the gastric funds, as submucosa arteriolar vessel erodes through mucosa

28
Q

What is the pathology of angiodysplasia

A

Vascular malformation that can occur anywhere in the GI tract

(see bleeding but cant locate)

29
Q

What is angiodysplasia associated with

A

Chronic conditions

e.g. heart valve replacement

Alimentary System: Pathology SA (27 decks)

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