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GI > Acute GI Bleeding > Flashcards

Acute GI Bleeding Flashcards

1
Q

define upper GI bleeding

A

bleeding from oesophagus, stomach or duodenum

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2
Q

lower GI bleeding

A

bleeding distal to duodenum

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3
Q

upper GI bleeding signs/ symptoms

A
  • haematemesis
  • malaena (partly digested blood)
  • elevated urea (digested blood becomes urea)
  • dyspepsia
  • reflux
  • epigastric pain
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4
Q

maleana

A

digested blood (has a dark/ black appearance in stool)

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5
Q

lower GI bleeding signs/ symptoms

A
  • fresh blood/ clots
  • magenta stools
  • normal urea
  • typically painless
  • commonly presents at an advanced age
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6
Q

causes of upper GI bleeding oesophagus

A

ulcers

varices

mallory weiss tear

malignancy

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7
Q

causes of stomach bleeding

A

gastric varicose

portal hypertensive gastropathy

malignancy

dieulafoy

angiodysplasia

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8
Q

causes of duodenal bleeding

A

anhiodysplasia

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9
Q

gold standard investigation of upper GI bleeding

A

endoscopy <24hours

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10
Q

causes of acute lower GI Bleeding

A

diverticular disease

haemorrhoids

vascular malformation

neoplasia

ischaemic colitis

IBD

radiation enteropathy/proctitis

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11
Q

What is required for the diagnosis of acute lower GI bleeding

A

flexible sigmoidoscopy

full colonoscopy

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12
Q

acute lower GI bleeding investigations

A

lower GI endoscopy:

  • flexible sigmoidoscopy
  • colonoscopy

CT angiography

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13
Q

acute lower GI bleeding - small bowel causes??

A
  • Meckels diverticulum
  • small bowel angiodysplasia
  • small bowel tumour
  • small bowel ulceration
  • aortoentero fistulation (following AAA repair)
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14
Q

acute lower GI bleeding small bowl investigations

A

CT angiogram

Meckels scan

capsule endoscopy

double balloon enteroscopy

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15
Q

Management of GI bleeding - circulatory system

A
  • wide bored IV access for IV fluids and blood transfusion
  • urgent blood samples
  • blood transfusion
  • catheter
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16
Q

Blatchfords Score - pre-endoscopy score

A
  • blood urea
  • haemoglobin
  • systolic blood pressure
  • other markers (e.g. hepatic disease, cardiac failure)
17
Q

low-risk criteria of Glasgow Blatchford Score (factors that mean you are at low risk)

A

urea <6·5 mmol/L
haemoglobin >=130 g/L (men) or >=120 g/L (women)
systolic blood pressure >=110 mm Hg
pulse <100 beats per min
absence of melaena, syncope, cardiac failure, or liver disease

18
Q

what age does acute lower GI bleeding occur?

A

mostly elderly

19
Q

what percentage of inpatients with a rectal bleed die

A

23%

20
Q

what drugs put you at an increased risk of lower GI bleeding

A

NSAIDs

Aspirin

GI (35 decks)

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