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Year 2 > GI Bleeding > Flashcards

GI Bleeding Flashcards

1
Q

What is Maleana?

A

Black tarry stools that occur due to upper GI bleeding.
This can be anywhere from the nose to the ascending colon.

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2
Q

Where does GI bleeding most commonly occur?

A

In the upper GI tract which consists of the oesophagus, stomach and duodenum. It typically occurs due to:
-> ulceration in the stomach or the duodenum
-> varices
-> gastroduodenal erosion

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3
Q

What are the causes of small bowel bleeding?

A

Diverticulum of the jejunum or ileum.
Malignancy of the small bowel, due to increased angiogenesis.

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4
Q

What are the causes of large bowel bleeding?

A

Carcinoma
Polyp
Ulcerative colitis or Crohn’s disease
Angiodysplasia

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5
Q

What is angiodysplasia?

A

Swollen, dialated blood vessels on the mucosa and submucosa of the GI tract, which is more common in older adults due to the breakdown of blood vessels.

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6
Q

What is diverticulitis?

A

Inflammation of the colon which causes pouches to protrude outwards.

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7
Q

What is diverticula’s disease?

A

Formation of outpockets on the walls of the intestine which become inflamed due to infection or autoimmunity.

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8
Q

What are haemorrhoids?

A

Renal veins form a venous plexus which is divided into
Internal haemorrhoid: above the pectinate line, which are typically painless and accompanied with mucous discharge
External haemorrhoid: below the pectinate line, which are painful especially on defaecation and blood clots can form. These haemorrhoids are palpable.

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9
Q

What causes haemorrhoid formation?

A

Increase in abdominal pressure from:
Weightlifting
Pregnancy
Obesity
Severe constipation

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10
Q

How does an acute upper GI bleed present?

A

Haematemesis
Maleana
Shock
Post-rectal bleed

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11
Q

How is an upper GI bleeding managed?

A

Resuscitation by:
Clearing blood from the pharynx
IV access to provide fluids
Prepare blood to replenish loss

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12
Q

Which patients are at risk of an upper GI bleed?

A

Elderly people over 65 years old
Co-morbidity with ischaemic heart disease
Low BP and high pulse rate

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13
Q

What is the Rockall scoring system?

A

Used to assess the severity of a GI bleed prior to endoscopy based on:
Age
Shock
Comorbidities

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14
Q

Which co-morbidities increase the risk of upper GI bleed?

A

Renal failure
Liver failure
Malignancy

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15
Q

What is obscure GI bleeding?

A

Bleeding with no detectable source, which commonly occurs in the small bowel.

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16
Q

What is the cause of obscure GI bleeding in under 40’s?

A

IBD
Lymphoma
Adenocarcinoma
Diverticulum

17
Q

What is the cause of GI bleeding in over 40’s?

A

Ulcers
Vascular lesions
Tumours

18
Q

How is a GI bleed treated?

A

Identify the source of active bleeding such as a clot or visible vessel
Provide therapeutic endoscopy within 24hrs of admission
Injection of adrenaline to reduce flow
Provide PPI prescription for ulcers

19
Q

What does colonoscopy indicate?

A

Cause of bleed
Prognosis
Provision of endoscopic therapy

20
Q

What does angiography indicate?

A

Need for angiographic intervention
CT/MRI angiography or femoral angiography

21
Q

How does a chronic GI bleed present?

A

Anaemia, accompanied by fatigue,shortness of breath and pallor.
Positive foecal occult blood test

22
Q

What is a foecal occult blood test? (FOB)

A

Screening diagnostic test to identify blood that is not visible in stools.

23
Q

Which medication causes GI bleeding?

A

NSAIDs
Anti-coagulants
Anti-platelets

24
Q

What is the response of the body to blood loss less than 15%?

A

Tachycardia

25
Q

What is the response of the body to GI blood loss between 15-40%?

A

Postural blood pressure drop

26
Q

What is the response of the body to GI blood loss over 40%?

A

Hypotension

27
Q

How is the urea-creatinine ratio affected in GI bleed?

A

Increases due to a lower circulating blood volume

28
Q

What is lower gastrointestinal bleeding?

A

Bleeding which is distal to the ligament of Treitz, which typically occurs in the colon and rectum.

29
Q

How does bleeding in the left colon present in faeces?

A

Fresh bright blood that may be mixed with clots in the stool.

30
Q

How does bleeding in the right colon present in faeces?

A

Maleana, with dark red blood mixed with the stools

31
Q

What is the cause of lower GI bleeds in under 50’s?

A

Malignancy
Diverticular disease
Ischaemia

32
Q

What is the cause of lower GI bleeds in over 50’s?

A

Haemorrhoids
Diverticular disease

Year 2 (227 decks)

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