Clinical Approach to GI Patient: UGIB Flashcards
1
Q
Acute UGIB location and cause
A
Proximal to the ligament of Treitz caused by PUD
2
Q
What are severe symptoms of acute UGIB?
A
Indicates anemia and hypovolemia
- orthosstatic dizziness
- confusion
- angina/tachy/severe palpations
- syncope
- weakness
- cold clammy
- SOB
3
Q
PE for UGIB?
A
- Resting tachycardia
- Orthostatic hypotension
- Supine hypotension
- Stool color can provide clue to bleed locatio but not reliable
- Acute abdomen rebound tenderness, guarding,severe pain
4
Q
What is the diagnositic and theraputic intervention for UGIB?
A
EGD with biopsy
5
Q
How do you tell if there is a perforation or obstruction with acute UGIB?
A
XR/CT/MRI
6
Q
How do you treat an acute UGIB?
A
- blood transfusion if indicated
- Hbg should rise ~1g/dL for each unit of transfused packed RBC’s
- PPI
- 2 large bore IV’s if shock
- abx if variceal bleed
7
Q
UGIB DDx?
A
- PUD
- Stress Ulcer
- Esophageal varicies
- Hemorrhagic gastritis
- ZES
- Mallory-Weiss Tear/Boerhaave syn
- Dieulafoy lesion
- GAVE syndrome
8
Q
Stress ulcers etiology HPI Diagnostics Tx and complicaitons?
A
aka Stress Related Mucosal Disease (SRMD)
- Burns, CNS damage, and severe surgical or medical illness (Stress)
- Very sick patient with signs of bleeding
- EGD
- PPI
- Prevent ulcers in ICU patients with PPI and enteral nutrition
- Bleeding is complicaiton
9
Q
Esophageal varicies
A
