Acute GI bleed

Question 1

what is thel and mark to distigquis the upper gi bleed and lower gi bleed

Answer 1

ligament of trizetz , just after the duodenum

Question 2

ligament of treitz connects

Answer 2

stomahc to edn point of the duodenum

Question 3

what is seen in upper gi bleed

Answer 3

haematemeis
malena
elvevated urea
dyspepsia nad epigastic pain
non steroidal anit inflatorys

Question 4

what is seen in lower gi bleed

Answer 4

fresh blood,
magenta stools
normal urea
painless
more common in advanced age

Question 5

causes of upper gi bleed in osephagus

Answer 5

osepuga
- ulcer
osepguaists
osgpuagla varices

mallory weiss tar
malignacy

Question 6

causes of bleed in stomach

Answer 6

stomach
ulcer
gastitus
varcies
malginacy
diulafoy
angiodysplasia

Question 7

casues of bleed in the duodenum

Answer 7

angiodysplasia
duodenal ulcer
duodenitis

Question 8

what is mallory weiss tera

Answer 8

damge to wall of the ospahgus, that tedns to treat itsel with ssacar tissue but cause large amount of bleeding, can be after retching and vomiting

Question 9

what is angiodyphagia

Answer 9

vascular malformgion, occurs anywerh itn teh gi tube, and can cuase non visible bleeding

Question 10

what is angiodusplai assoiced with

Answer 10

chonc condios such as heartvalve repalcement

Question 11

what is dieulafoy

Answer 11

submosua arterkola vessle eroding though gsatic fundus

Question 12

most common type of acute gi bleed

Answer 12

peptic ulcer, gastitis, ophagus, errosive duodena and verices

Question 13

what isthe presentiang complaitn asosiced with pepitc ulcer bleeed

Answer 13

dypepsia, colape, poor urine output large volume meleman, or heamtis

Question 14

what is the past medical history of peptic ulcer bleed

Answer 14

liver diseas

Question 15

what isthe drug hisoty of peptic ulcer bleed

Answer 15

nsaids, anticolagia anti platelet agents

Question 16

what is the social hisotory assoiced with peptic ulcer bleed

Answer 16

alcho, smoking, ivdu

Question 17

what ishte family history assoiced with peptic ulcer bled

Answer 17

h pylori and family memebr swith peptic uclers

Question 18

what is zollinger ellison sydnodm

Answer 18

ganstin sectioern pancratic tumoru, cuase redoccure duodenal ulcers

Question 19

how to diagnos gastic ucler sitting over gastic cancer

Answer 19

repeat endocy at 8 weeks for anyone with a gastic ulcer

Question 20

medication that makeupper gastits more likely

Answer 20

anti cogaloians
anti plateltes

Question 21

risk factos for ospghual bled

Answer 21

bisphospahates
alchol
hitaut
herna
gord
systemic ilnes

Question 22

what percent of varcies are osphgaual

Answer 22

90%

Question 23

cause of lower gi bleed in colonic paitens

Answer 23

diverticulatis disaesr
hamorroids
vasuclar malformations
neplasia
ishcmia colitis
ration / enteropya procitis
ibvs

Question 24

what is diffenrce between sigmodi socpy and colonoscoly

Answer 24

length, sigmodisocpy just colon

Question 25

what is diverticular diseae

Answer 25

protusion of inner mucla lining though teh outer muclar layer forming a poch

Question 26

what are seeni in diclar disase

Answer 26

inflation and occusonbleeing

Question 27

what is hameorooids

Answer 27

enlaged vascualr cusion aroudn anal canal

Question 28

what caus harod to be painful

Answer 28

if they are thormbosed or exposed

Question 29

what cuase hamotide

Answer 29

low fiber, hihg fat dieta and consipion

Question 30

what is the treatment for haotis

Answer 30

elective surgy

Question 31

how much bleeding is from colonc nepolasy

Answer 31

large anmont of bleeding can occur

Question 32

what is ishcmia coloitis

Answer 32

distucito of blood flow to colon due to venous conjuseion,

Question 33

wher does ischemic clolits normally effect

Answer 33

desceing / sigmod colon

Question 34

sympon fo iscm coliginss

Answer 34

crampy abomail pain

Question 35

what is cuase of radiation proctitis

Answer 35

cervial cancr or prosta cancer radiotharpyy treatmnet

Question 36

what is th treatmnet for radiation procitis

Answer 36

blood tranfusions apc (ionised gas to parts of digestive tract) sulcrafate enemas - helps to form protective coat on gi tract hyperbaric oxygen

Question 37

what is uc or chons diseas assoiced with

Answer 37

bleedin and diharrea symptons

Question 38

what is the small bowl cause that can cause lower gi bleed

Answer 38

meckels diverticulum small bowel angiodysplasia small bwl tumour small bowel fistulation (after aaa repari) small bowel ucleration (nsaids)

Question 39

merckels diverticulum

Answer 39

small pocket that is misformed bowel or connection to other bowel.

Question 40

what investivagion cna be done to look for smal gi bleed

Answer 40

meckels scna ( capsule endocpy double ballon endocpys ct antiongigarmm

Question 41

fucniton of duouble baloon endocpy

Answer 41

aloows you to move bowl, so you don't need to take full bolwe length

Question 42

what is meckels scan

Answer 42

looks for abdomalr gastic mucosa

Question 43

what needs to be done to manage cirucation ni acute gi bleed

Answer 43

iv bore urgent blood samles blood trnafiohn catherter to mesuare urine output

Question 44

what are signs of shock

Answer 44

high resp rate rapid pulse anxitety or confusion cool clammy skin low urine output low bp

Question 45

what are the 4 classes of shock and blood los assoicaed with them

Answer 45

1 - less than 750 ml 2 - 750 - 1500 3 - 1500- 2000 4 >2000ml

Question 46

what is the score for upper gi bleed

Answer 46

ugib , roakall score glasgow blatford score

Question 47

disadvage of rocker socre

Answer 47

needs endocpy for full socre

Question 48

benfifis of glasoglw blatfo score

Answer 48

does not reuire endocopy

Question 49

what is included in glasgow blatfoc score

Answer 49

urea haemoglobing systolic blood pessue pulse absocel of melaena , sycome and cardiac faure

Question 50

what is the rockwall score componatns

Answer 50

Age Features of shock (e.g., tachycardia or hypotension) Co-morbidities (2 doubles risk) Cause of bleeding (e.g., Mallory-Weiss tear or malignancy) Endoscopic findings of recent bleeding (e.g., clots and visible bleeding vessels)

Question 51

how long to do a upper gi endocpy

Answer 51

within 24 hours once stable

Question 52

how long to do a colonospcy

Answer 52

colonoscpy or ct angiogram

Question 53

what addinoal medication can help with gi bleed

Answer 53

ppi and coagulatins

Question 54

treatment for peptic ulcer bleeed

Answer 54

endosocpy, ppi, angiograpty with empbolsion, laparotomy, adrenaline treaptmen, mechanical clip

Question 55

treamnt of varices bleed

Answer 55

terlipresin, antibioci, reverse abnoarmy coaguation, senstaken blackermore tube, tipps

Question 56

what is th role of terlipressin

Answer 56

vasocontstitor to the splanic blood supply , reduce blood flow to porar vein reducing portal pressures

Question 57

what is tipss

Answer 57

transjugualr intrahepatic portosystmeic shunt (shunt that goes over from portal vein to veina cava, reducing portal hypertions

Question 58

what is a shenstaken blakemore tube

Answer 58

a tube infserted into nose, that inflates ballon in stomach and in the lower oepsgua stand comes bleeding