GI bleeds Flashcards

1
Q

What is the presentation of upper GI bleeding?

A

Haemetemesis
Coffee ground vomit
Malaena
Upper GI discomfort, nausea

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2
Q

What are the common causes of upper GI bleeds?

A

Duodenal ulcer
Gastric ulcer
Gastric erosions
Mallory Weiss tear

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3
Q

What are the features of a duodenal ulcer?

A

Epigastric pain relieved by eating
Haemetemesis
Malaena

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4
Q

What are the features if a gastric ulcer?

A

Typically low volume bleeds–> iron deficiency anaemia

Epigastric pain made worse by eating

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5
Q

What are the features of gastric erosions?

A

HAematemesis
Malaena
Epigastric discomfort

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6
Q

What are the causes of gastric erosions?

A

NSAIDs, alcohol, stress…

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7
Q

What causes a Mallory Weiss tear?

A

Repetitive vomiting

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8
Q

What are the features of a Mallory Weiss tear?

A

Small volume of bright red blood after vomiting bout

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9
Q

What are the less common causes of upper GI bleeding?

A

Malignancy
Oesophageal varices
Oesophagitis
Gastric varices

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10
Q

What are corroborating symptoms of malignancy with upper GI bleed?

A

Dysphagia, odynophagia

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11
Q

What are the features of oesophageal varies?

A

Large volumes of fresh blood, can cause haemodynamic compromise
Portal hypertension
Malaena, nausea

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12
Q

What are the features of oesophagitis?

A

Small volumes of fresh blood

History of GORD

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13
Q

What investigations are done for upper GI bleed?

A

FBC, U&Es, LFTs- high urea, low Hb
Coagulation screen
Endoscopy

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14
Q

What tool is used to assess for intervention in upper GI bleed?

A

Blatchford score
0= low risk
All others considered high risk

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15
Q

What are the features of a lower GI bleed?

A

Dark red blood= right sides
Bright red= left sided
Fresh= rectum

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16
Q

What are the causes of lower GI bleeds?

A
Diverticular disease
Cancer
Haemorrhoids
Colitis
UC
Angiodysplasia
17
Q

What are the features of diverticular disease?

A

Large volume dark red bleeding

18
Q

What are the features of colorectal cancer?

A

Blood in stool
Iron deficiency anaemia
Change in bowel habit
Weight loss, anorexia, N&V

19
Q

What are the features of haemorrhoids?

A

Bright red blood post defection
Pain/itching
History of straining etc

20
Q

What are the features of colitis?

A

Bloody diarrhoea
Abdo tenderness
Fatigue, weight loss, anorexia

21
Q

What are the symptoms of UC?

A

Bloody diarrhoea

Abdo pain

22
Q

What is angiodysplasia?

A

Vascular deformity of GI tract, usually seen in elderly

23
Q

What are the features of angiodysplasia?

A

Older patient\
Dark red blood
Varying volumes- can be massive

24
Q

What investigations are done for lower GI bleeding?

A

Bloods- iron deficiency anaemia
Coag screen
Colonoscopy
PR exam and proctosigmoidoscopy in haemorrhoids