Upper GI bleeding Flashcards Preview

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Flashcards in Upper GI bleeding Deck (11):
1

Malaena =

more than 400ml of blood
black stool
distinct smell - differentiates from Fe tablets/medication causes of black stool

2

Arterial bleeds are treated by (3)

injection (adrenaline)
heater probe
clips to ligate

3

Treatment of angiodysplasia (small red bleeds)

argon plasma coagulation
RF ablation

4

Endoscopy is contraindicated in -

recent infarct
anticoagulation therapy/ bleeding diathesis
infection risk

5

4 main causes of upper GI bleeding commonest to least common

duodenal ulcer
gastric erosions
gastric ulcer
varices

6

Initial management of all upper GI bleeds

resuscitation
airway protection
O2
IV access (2 large bore grey cannula in antecubital fossa)
fluids

7

Risk scores for severity of upper GI bleed

Rockall - pre and ost endoscopy
Blatchford - pre endoscopy stratifies and shows urgency of endoscopy

8

___ is used to identify cause of and treat upper GI bleeds

Endoscopy

9

Stigmata of recent upper GI bleed =

active bleeding/oozing
overlying clot
visible vessel (nipple sign - fibrin clot on small clot)

10

Treatment for ulcer bleed

endoscopy (2 attempts at most) =
inject adrenaline and heater probe coagulation together = 1st line
clip
haemospray - bridge
IV omeprazole for acid suppression

11

Treatment of variceal bleeding

terlipressin = splanchnic vasoconstrictor and good for renal perfusion
endoscopic ligation
sclerotherapy
Sengstaken-Blakemore tube - balloon tamponade
TIPS if all else fails