GI Bleeding

Question 1

Basic steps in initial managment of an active GI Bleed

Answer 1

Assess volume status
Replace fluid - 2 large bore peripheral IV’s
Type and cross for transfusion

Question 2

Brisk, self limited bleeds with bright red blood in stool

Answer 2

Diverticular bleeding

Question 3

Epigastric pain, weight loss, melena, history of NSAID use.

Answer 3

PUD

Question 4

Brisk bright red bleed in a patient with end-stage renal disease

Answer 4

Angiodysplasia

Question 5

Bright red bleed, history of anemia, changing bowel habits

Answer 5

colon cancer.

Question 6

Where is the bleed? - Nausea, vomiting, hematemesis or coffee ground emesis, melena, elevated BUN/Cr, hypotension.

Answer 6

Upper Gi

Question 7

Where is the bleed? Hematochezia,

Answer 7

Lower GI

Question 8

Upper GI bleed following an episode of severe vomiting

Answer 8

Mallory-Weiss tear.

Question 9

Heavy upper GI bleed with a history of long-term alcohol abuse

Answer 9

Esophageal variceal hemorrhage. Especially with evidence of cirrhosis and/or portal hypertension.

Question 10

Painful bright red blood per rectum

Answer 10

External Hemorrhoids or anal fissure

Question 11

Painless bright red blood per rectum

Answer 11

Internal Hemorrhoids