Occult GIB

Question 1

What is an Occult GI bleed?

Answer 1

Bleeding that is NOT apparent to the patient

not visible

Question 2

What are the 2 most common causes of occult GI bleeding with Iron Deficient Anemia?

Answer 2

1. Neoplasm

2. Vascular abnormalities (angioectasia/AVMs)

Question 3

What are the 2 most common causes of occult GI bleeding with Iron Deficient Anemia?

Answer 3

1. Neoplasm

2. Vascular abnormalities (angioectasias/AVMs)

Question 4

In pre-menopausal women, is Iron Deficient Anemia normal?

Answer 4

Yes

Question 5

In a person older than 45 with iron deficient anemia, what should you suspect?

Answer 5

Colon cancer

Question 6

In a person older than 45 with iron deficient anemia, what should you suspect?

Answer 6

Colon cancer

Question 7

What are the symptoms of an Occult GI bleed?

Answer 7

Iron Deficient Anemia in ABSENCE of visible blood loss

Question 8

What are the symptoms of an Occult GI bleed?

Answer 8

Iron Deficient Anemia in ABSENCE of visible blood loss

Question 9

In a patient with an Occult GI bleed, what should you evaluate for?

Answer 9

Celiac Disease

Question 10

What tests will be (+) with an Occult GI bleed?

Answer 10

Fecal occult blood test

Fecal immunochemical test

Question 11

What are 3 screenings for an Occult GI bleed?

Answer 11

Fecal occult blood test
Fecal Immunochemical test
Fecal DNA test

Question 12

What can cause a false (+) for the fecal occult blood test?

Answer 12

Red meat, iron, aspirin, UGIB

Question 13

What can cause a false (-) for the fecal occult blood test?

Answer 13

Vitamin C, intermittent bleeding

Question 14

The Fecal Immunochemical test is sensitive to?

Answer 14

Hemoglobin

Question 15

Which Occult GI bleed test is more sensitive to colorectal cancer and adenomas?

Answer 15

Fecal Immunochemical Test

Question 16

Colon cancer usually occurs in those older than?

Answer 16

45

Question 17

When should you start screening for Colon Cancer?

Answer 17

45

Question 18

When should you start screening for Colon Cancer?

Answer 18

45

Question 19

What do most Colon Cancers arise from?

Answer 19

Adenomatous polyps

Question 20

There is high prevalence of colon cancer in patients with?

Answer 20

Streptococcus Bovis (gallolyticus) Bacteremia

Question 21

There is high prevalence of colon cancer in patients with?

Answer 21

Streptococcus Bovis (gallolyticus) Bacteremia

Question 22

Where does colon cancer usually metastasize?

Answer 22

Liver

Question 23

Left sided colon cancer symptoms?

Answer 23

Change in bowel habits

Bleeding

Question 24

Right sided colon cancer symptoms?

Answer 24

Anemia
Weight loss
Occult blood in stool

Question 25

Bleeding and altered bowel habits may indicate colon cancer on the ___ side

Answer 25

LEFT

Question 26

Anemia, weight loss and occult blood in stool may indicate colon cancer on the ____ side

Answer 26

RIGHT

Question 27

What is the gold standard for detecting colon cancer?

Answer 27

Colonoscopy

Question 28

What does a Barium enema show with colon cancer?

Answer 28

Apple core sign

Question 29

In those with Arteriovenous Malformations (AVMs)/Angioectasias, what may be history items?

Answer 29

``` Occult GI bleed Painless bleeding (melena, hematochezia) ```

Question 30

Arteriovenous Malformations (AVMs)/Angioectasias are common in patients with what conditions?

Answer 30

Renal failure | Aortic Stenosis

Question 31

What are the symptoms of Arteriovenous Malformations (AVMs)/Angioectasia?

Answer 31

Iron deficient anemia with NO cause

Question 32

Patients older than 60 with Occult GI bleed and a normal endoscopic evaluation you should consider?

Answer 32

Angioectasias/AVMs

Question 33

Patients older than 60 with Occult GI bleed and normal endoscopic evaluation you should consider?

Answer 33

Angioectasias/AVMs

Question 34

Occult GI bleed with normal endoscopic evaluation?

Answer 34

Angioectasias/AVMs

Question 35

Unintentional weight loss

Answer 35

Loss of 5-10% of body weight over 6 months

Question 36

Patients with unintentional weight loss should get what things done during a physical exam?

Answer 36

Weigh them Fecal Occult Blood Test Screen for depression

Question 37

Males with unintentional weight loss should get what exams?

Answer 37

Prostate and rectal exam

Question 38

Females with unintentional weight loss should get what exams?

Answer 38

Pelvic

Question 39

Patients with unintentional weight loss should get what things done during a physical exam?

Answer 39

Weigh them Fecal Occult Blood Test Screen for depression