L19: GI Bleeding Flashcards
(175 cards)
1
Q
Def of Hematemsis
A
2
Q
Def of Melena
A
3
Q
Def of Hematochezia
A
4
Q
Hematochezia infrequently occurs with massive ….. GI bleeding that is typically associated with hypotension.
A
Upper
5
Q
Hematemesis and relena usually indicate ….. GI bleeding …… to the suspensory ligament of the duodenum, also called the ligament of …..
A
Upper, proximal, Trietz
6
Q
……. is the most common cause of upper GI bleeding.
A
Peptic ulcer disease (PUD)
7
Q
Hematochezia is most often associated with ….. Gl bleeding.
A
lower
8
Q
Gastrointest nal bleeding indicates underlying pathology in either the upper or lower gastrointestinal (Gl) tract.
A
9
Q
Diagnosis is nade by clinical history and physical exam, followed by upper and /or lower Gl endoscopy
A
10
Q
The source of the bleeding can usually be identified and treated with endoscopy.
A
11
Q
Incidence of UGIB
A
12
Q
Risk Factors of UGIB
A
13
Q
Incidence of LGIB
A
14
Q
Risk Factors of LGIB
A
15
Q
Most Common Causes of UGIB
A
16
Q
The source of bleeding is not identified in up to …..
A
(10%- 15%) of patients.
17
Q
Esophageal Causes of UGIB
A
18
Q
Gastric Causes of UGIB
A
19
Q
GAVE
A
20
Q
Dieulofy Lesions
A
21
Q
Angiodysplasia
A
22
Q
Duedenal Causes of UGIB
A
23
Q
Diverticular Causes of LGIB
A
24
Q
Diverticulosis
A
25
Diverticulitis
26
Meckel Diverticulum
27
Angiodysplasia as a cause of **LGIB**
28
Ischemia
29
Internal Hemorrhoides
30
Anal Fissure
- Cause of **LGIB**
31
Neoplastic Causes of **LGIB**
32
Inflammatory Causes of **LGIB**
33
Iatrogenic Causes of **LGIB**
34
Aortoenteric Causes of **LGIB**
35
Asymptomatic **GI Bleeding**
36
Anemia in **GI Bleeding**
37
Pain & Heartburn in **GI Bleeding**
38
CP of **GI Bleeding**
- UGIB
CP of **GI Bleeding**
- Melena
39
CP of **GI Bleeding**
- Hematochezia
40
CP of **GI Bleeding**
- Weight Loss
41
Patients with mild or occult bleeding may .....
not have significant findings.
42
Genral Examination in **GI Bleeding**
43
The approach to evaluating patients with GI bleeding ........ and whether the patient is able to undergo endoscopic evaluation.
depends on its severity
43
Rectal Examination in **GI Bleeding**
44
Liver Examination in **GI Bleeding**
45
Diagnosis and management are often approached concurrently.
...
46
Approach to Dx & TTT of **GI Bleeding**
47
Approach to Dx & TTT of **GI Bleeding**
- Initial Stabilization
48
Approach to Dx & TTT of **GI Bleeding**
- Initial Stabilization (Airway & Breathing)
49
Approach to Dx & TTT of **GI Bleeding**
- Initial Stabilization (Circulation)
50
Approach to Dx & TTT of **GI Bleeding**
- Initial Assessment
51
Approach to Dx & TTT of **GI Bleeding**
- Initial Assessment (CBC)
52
Approach to Dx & TTT of **GI Bleeding**
- Initial Assessment (Blood Type & Cross-Match)
53
Approach to Dx & TTT of **GI Bleeding**
- Initial Assessment (Coagulation Factors)
54
Approach to Dx & TTT of **GI Bleeding**
- Initial Assessment (FOBT)
55
Approach to Dx & TTT of **GI Bleeding**
- Initial Assessment (LFTs)
56
Approach to Dx & TTT of **GI Bleeding**
- Initial Assessment (Basic Metabolic Panel)
57
Approach to Dx & TTT of **GI Bleeding**
- Initial Assessment (Anemia Workup)
58
Indication for blood transfusion in **GI Bleeding**
59
Indication for blood transfusion in **GI Bleeding**
- Hemodynamically stable without cardiovascular disease
60
Indication for blood transfusion in **GI Bleeding**
- Hemodynamically stable with cardiovascular disease
61
Indication for blood transfusion in **GI Bleeding**
- Patients who require massive transfusion
62
Drugs to stop & Continue in **GI Bleeding**
63
Interventions for **GI Bleeding** after Resuscitation
64
Interventions for **GI Bleeding** after Resuscitation
- For Hemodynamically Unstable
65
Interventions for **GI Bleeding** after Resuscitation
- For Hemodynamically Stable
66
Interventions for **GI Bleeding** after Resuscitation
- For Hemodynamically Stable (Suspected UGIB)
67
Interventions for **GI Bleeding** after Resuscitation
- For Hemodynamically Stable (Suspected LGIB)
68
Most patients with ....... require hospitalization for management and to ensure the patient is stable.
UGIB
69
...... may be managed as an outpatient in patients at low risk of adverse outcomes.
LGIB
70
About ..... of cases of GI bleeding will stop without intervention.
80%
71
Indications for admission & referral in **GI Bleeding**
72
Bleeding Scoring Systems in **GI Bleeding**
73
Glascow-Blatchford Bleeding Score
74
Use of Glascow-Blatchford Bleeding Score
75
Importance of Glascow-Blatchford Bleeding Score
76
Factors Considered in Glascow-Blatchford Bleeding Score
77
Assessment of Glascow-Blatchford Bleeding Score
78
**Rockall Bleeding Score**
79
Uses of **Rockall Bleeding Score**
80
When is **Rockall Bleeding Score** Applied?
81
Factors Considered in **Rockall Bleeding Score**
82
Assessment of **Rockall Bleeding Score**
83
**Oakland Bleeding Score**
84
Uses of **Oakland Bleeding Score**
85
Factors Considered in **Oakland Bleeding Score**
86
Assessment in **Oakland Bleeding Score**
87
DDx of **GI Bleeding**
88
Causes of **Epistaxis**
89
Diffrentiation of **Epistaxis** from GI Bleeding
90
Managment of **Epistaxis**
91
Some foods or medicines can cause false positive fecal occult testing like ......
92
....... can cause black, tarry stools that are negative for fecal occult
Bismuth
93
Patients should avoid these foods and medications ...... before fecal occult blood testing.
48 hrs
94
Cause of **Hemoptysis**
95
Def of Hemoptysis
96
Dx of **Hemoptysis**
97
TTT of Hemoptysis
98
Managment of Massive **GI Bleeding**
99
managment of Moderate **GI Bleeding**
100
Managment of Mild **GI Bleeding**
101
What should you exclide first in managment of **GI Bleeding**?
102
Investigations in **GI Bleeding**
103
Indication of CT with angiography (CTA)
104
Procedure of **CT with angiography (CTA)**
105
Procedure of **Radionuclide imaging**
106
Indications of **Radionuclide imaging**
107
Types of **Endoscopy** in GI Bleeding
108
Types of **Endoscopy** in GI Bleeding
- Esaphagoduodenoscopy
109
Types of **Endoscopy** in GI Bleeding
- Colonoscopy
110
Endoscopic interventions to achieve hemostasis (successful in most cases)
111
Procedure of Capsule endoscopy
112
Indications of Capsule endoscopy
113
Other Procedures in Investigations **GI Bleeding**
114
Other Procedures in Investigations **GI Bleeding**
- NGT
115
Other Procedures in Investigations **GI Bleeding**
- Angiography
116
Other Procedures in Investigations **GI Bleeding**
- VC & Embolization
117
Other Procedures in Investigations **GI Bleeding**
- Balloon Tamponade
118
Other Procedures in Investigations **GI Bleeding**
- Surgery
119
**Medications for UGIB**
120
**Medications for UGIB**
- PPIs
121
**Medications for UGIB**
- PPIs (Examples)
122
**Medications for UGIB**
- PPIs (Dosing)
123
**Medications for UGIB**
- PPIs (advantages_
124
**Medications for UGIB**
- Prokinetic Drugs
125
**Medications for UGIB**
- Prokinetic Drugs (MOA)
126
**Medications for UGIB**
- Prokinetic Drugs (Drugs)
127
**Medications for UGIB**
- Vasoactive Meds
128
**Medications for UGIB**
- Vasoactive Meds (MOA)
129
**Medications for UGIB**
- Vasoactive Meds (Uses)
130
**Medications for UGIB**
- Antibiotics
131
**Medications for UGIB**
- Antibiotics (Indications)
132
**Medications for UGIB**
- Antibiotics (Drugs)
133
**Medications for UGIB**
- Non-Aspirin NSAIDs Should be Avoided
134
Common Causes of LGIB In Adults
135
Def of **Angiodysplasia/AV Malformations**
136
Sex in **Angiodysplasia/AV Malformations**
137
Age in **Angiodysplasia/AV Malformations**
138
RF for **Angiodysplasia/AV Malformations**
139
Incidence of **Angiodysplasia/AV Malformations**
140
CP of **Angiodysplasia/AV Malformations**
141
Site of **Angiodysplasia/AV Malformations**
142
MR of **Angiodysplasia/AV Malformations**
143
TTT of **Angiodysplasia/AV Malformations**
144
Types of **IBD**
145
CP of **IBD**
146
Extra-Intestinal Manifestations of **IBD**
147
CP & TTT of **IBD**
148
Incidence of **Ischemic Colitis**
149
RF for **Ischemic Colitis**
150
Sites of **Ischemic Colitis**
151
CP of **Ischemic Colitis**
152
TTT of ****Ischemic Colitis****
153
Causes of **Infectious Colitis**
154
Pathogenesis of **Infectious Colitis**
155
CP of **Infectious Colitis**
156
CP of **Neoplasms in LGIB**
157
Sites of **Neoplasms in LGIB**
158
Incidence of **Neoplasms in LGIB**
159
Types of **Neoplasms in LGIB**
160
Types of **Neoplasms in LGIB**
- Benign
161
Types of **Neoplasms in LGIB**
- Malignant
162
Causes of **LGIB in Children & Adolescents**
163
Causes of LGIB
164
Incidence of **Meckel's Diverticulum**
165
Site & Origin of **Meckel's Diverticulum**
166
CP of **Meckel's Diverticulum**
167
Cause of Bleeding in **Meckel's Diverticulum**
168
Def of **Intussuseption**
169
CP of **Intussuseption**
170
INVx & TTT of **Intussuseption**
171
INVx in **Anal Fissure**
172
Baby + Vomiting + Bloody Stool + Tense Painful abdomen ----> ........
173
TTT of Esophageal Varies
174
Vomiting & BPR are .... in intussessption
## Footnote
Bleeding PUD can cause Hemodynamic Instability
