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Robbins Pathology GI (Chptr 16,17,18,19) > Clincal Disorders-GI Bleeding > Flashcards

Clincal Disorders-GI Bleeding Flashcards

1
Q

For a patient admitted to the ICU, what should immediately be places

A

Two large bore (18 gauge or larger) IV lines

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2
Q

What is given to patients with a bleeding varices

A

FFP/platelets

Vitamin K IV

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3
Q

What are the most common caused of acute lower GI bleed in patients under 40

A

Neoplasms, Crohn’s disease, celiac, and Meckels

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4
Q

What is the method of diagnosis for an acute lower GI bleed

A

Colonoscopy

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5
Q

If hypertension is present with a ulcer proliferation, which other conditions need to be looked at

A
  • Ruptured aortic aneurysms
  • Mesenteric infarction
  • Acute pancreatitis
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6
Q

Which side is more common for ovarian torsion

A

Right side because of increased length of utero-ovarian ligament, with the left having the sigmoid colon present to restrict movement

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7
Q

What are the factors that can increase the risk for an ectopic pregnancy

A

History of infertility, PID, ruptured appendix, and tubal surgery

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8
Q

What is the most common cause of lower GI bleeds

A

Diverticulosis

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9
Q

What is the treatment for someone with ulcer perforation

A
  • Laproscopic perforation closure

- Nasogastic suction, PPI, broad spectrum antibiotics

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10
Q

What drugs are given to patients with a bleeding varices

A

Third gen cephalosporin
Fluoroquinolones
-Somatostatin and octreotide (vasoconstrictors)

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11
Q

What is a dieulafoy lesion

A

Large caliber submucosal artery

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12
Q

What is gastric outlet syndrome

A

Edmena or narrowing of the pyloric or duodenal bulb, commonly now seen with an intraabdominal neoplasm

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13
Q

What are the characteristics of symptoms for ischemic colitis

A

Crappy abdominal pain, followed by bloody diarrhea

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14
Q

What is the telangiectasias

A

Small cherry red lesions cause by dilation of venules

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15
Q

What are some of the things that can bring on ischemia colitis

A

-Long distance running, vasculitis, CAD, estrogen therapy

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16
Q

What is the diagnosis for liver penetration

A

Endoscopy confirms ulceration and abdominal CT shows penetration

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17
Q

What is occult GI bleeding

A

Bleeding in the feces that is no apparent to the patient

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18
Q

What age group of boys typically presents with the testicular torsion

A

12-18

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19
Q

In the case of ulcer proliferation, what are present for the diagnosis

A

Leukocytosis
Mild elevation of amylase
Abdominal CT

20
Q

What conditions are seen to have large numbers of telangiectasias

A

Hereditary hemorrhagic telangiectasia aka Osler Weber Rendu or CREST

21
Q

What is the most common cause of maternal death during the first trimester

A

Undetected ectopic pregnancy

22
Q

What is the treatment for a patient with an upper GI bleed

A

IV or oral PPI

Octreotide (reduces blood flow)

23
Q

In patients with iron deficiency anemia should be evaluated for which possible conditions

A

Celiac disease with a IgA anti-TTG or biopsy

24
Q

What is given to patients with history of bleeding varices in order lower risk of rebleeding

A

Beta blockers

25
Q

What does black stools, aka melana indicative of with regards to the location of the bleed

A

Proximal to the ligament of the trietz

26
Q

What is the diagnostic approach to GI hemorrhage

A

Endoscopy (EGD)

27
Q

Which form of ulcer penetration is the worse

A

Posterior because it goes into the pancreas, liver, and biliary tree

28
Q

What is the most reliable method of detection and treatment of Meckels diverticulum

A
  • Detection: technetium 99 scan

- Treatment: surgical resection

29
Q

What are the conditions that commonly are assocaited with Toxic megacolon

A
  • UC
  • C. Difficile
  • Chagas
  • Oglivie
30
Q

What is the location of an acute lower GI bleed

A

-Distal to the ligament of Treitz

31
Q

What is the common symptom seen for a GI hemorrhage

A

“Coffee ground” emesis

32
Q

What si the treatment for acute mesenteric ischemia

A

Laparotomy

33
Q

What is the most common associated finding with ovarian torsion

A

-ovary greater that 4 cm due to a cyst, tumor, edema

34
Q

What is antioectesias

A

Aberrant submucosal Vessels caused by chronic blockage of veins, usually in the right colon

35
Q

What are the most common causes of lower Gi bleeds in patients over the age of 50

A

Diverticulosis, angectasias, malignancy, or ischemia

36
Q

Which preexsting conditions will predispose a patient to diverticulosis

A

Marfans, Ehlers-Danilo’s, scleroderma

37
Q

How is occult GI bleeding identified

A
  • positive fecal occult blood test (FOBT)
  • fecal immuno Chemical test (FIT)
  • Iron deficiency due to the bleeding
38
Q

Which patients are angiodysplasias seen

A

Over 70 with chronic renal failure

39
Q

What are the symptoms of an ulcer penetration

A

More diffuse pain since the pancreas is now involved, unresponsive to antacids

40
Q

What are the drugs that increase the risk factors for lower GI bleed

A

ASA, nonASA antiplatlets, NSAIDs

41
Q

What is the primary method of diagnosis for ovarian torsion

A

Transvaginal Ultrasound with Doppler

42
Q

What are the symptoms of vascular disorders of the small and large intestine

A
  • Extremely painful, but the abdominal exam will be fairly normal, may look like they are faking
  • Fear of food
  • Thumbprinting on scan
43
Q

What is the prognosis of diverticulosis bleeding

A

Usually the ascending colon and is self limiting

44
Q

What are the risk factors for bleeding from esophageal varices

A

-Size
-presence of red wale markings (longitudinal dilated venules on the surface)
-Severity of the liver disease
Active alcohol abuse

45
Q

What should be done for all patients with UGIB and what are the benefits

A

Upper endoscopy because:

  • Find source of bleed
  • Find risk of rebleeding and guiding triage
  • Render endoscopic therapy
46
Q

What is the diagnostic method of choice of an acute mesenteric ischemia

A

CT angiography

Robbins Pathology GI (Chptr 16,17,18,19) (32 decks)

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