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Flashcards in Acute Gastrointestinal Bleeding Deck (23):
1

What is the structure used to determine whether a bleed is upper or lower GI?

Ligament of Treitz

2

What are the risk factors for peptic ulcers?

Helicobacter pylori
NSAIDs
Alcohol abuse
Smoking
Systemic illness

3

What are the risk factors for gastritis?

Helicobacter pylori
NSAIDs
Alcohol

4

What are the risk factors for duodenitis?

Helicobacter pylori
NSAIDs

5

What are the risk factors for oesophagitis?

Reflux
Alcohol
Bisphosphonates

6

What is the major cause of varices?

Portal hypertension

7

What are the causes of upper GI bleeds?

Peptic ulcer
Oesophagitis
Gastritis
Duodenitis
Varices
Malignancy
Mallory Weiss tear

8

What is a Mallory Weiss tear?

Tear in the oesophageal mucosa

9

What are the symptoms of a Mallory Weiss tear?

Retching
Vomiting

10

What are the causes of lower GI bleeds?

Diverticular disease
Angiodysplasia
Ischaemic colitis
Haemorrhoids
IBD

11

What is diverticular disease?

Protrusion of the inner mucosal lining through the outer muscular layer forming a pouch

12

What are the clinical signs associated with upper GI bleeds?

Haematemesis
Malaena
Dyspepsia

13

What are the clinical signs associated with lower GI bleeds?

Fresh or altered hematochezia

14

What are the initial investigations used in GI haemorrhages?

Bloods
Blood gas
12 lead ECG
Pulse
Resp rate

15

What is used to assess the severity of a GI haemorrhage?

Rockall score or Glasgow-Blatchford score

16

What is given in the resuscitation step of managing a GI bleed?

Fluid (crystalloid)
Blood products (packed red cells, platelets)
Avoid excessive transfusion

17

What is shock?

Circulatory insufficiency resulting in inadequate oxygen delivery, hypo perfusion and tissue hypoxia

18

What are the clinical signs of shock

Hypovalaemic
Tachypnoea
Anxiety/confusion
Tachycardia

19

What is the management step of GI bleeds?

Stop harmful medications
Reversal of harmful medications
Correct coagulopathy
Endoscopic therapies

20

What is the management of non variceal haemorrhages?

Endoscopic therapies
Proton proton inhibitors post endoscopy

21

What are the risk factors for variceal haemorrhages?

Signs and history of chronic liver disease
Known varices

22

What are the complications of variceal haemorrhages?

Sepsis
Renal failure
Encephalopathy

23

What is the management of variceal haemorrhages?

Avoid saline in cirrhotics
Platelets
Coagulopathy
Terlipressin
Antibiotics
Sengstaken-Blakemore tube
Endoscopic (glue injection, band ligation)