upper GIB

Question 1

What is the most common condition leading to hospitalization in the us

Answer 1

GIB

Question 2

What organs are considered in an upper GIB

Answer 2

Esophagus, stomach, duodenum

Question 3

What are s/s of an upper GIB

Answer 3

Hematemesis: bright red
Bloody stools melena
Lightheadedness, syncope, angina, SOB
Elevated BUN

Question 4

What is the most common cause of upper GIB

Answer 4

Peptic ulcers

Question 5

S/s of peptic ulcer bleed

Answer 5

Bleeding/anemia, early satiety, unexplained weight loss, progressive dysphagia, recurrent vomiting, severe/sharp abdominal pain

Question 6

Diagnosis and treatment of peptic ulcer disease

Answer 6

EGD: ulcer
TX: acute: protonix 80mg IV loading then 8mg/hr drip consult GI

Question 7

Peptic ulcer prevention

Answer 7

Eradicate h. Pylori
Avoid NSAIDS and anticoagulation
Reduce acidic secretions

Question 8

What causes a Mallory Weiss tear

Answer 8

Vomiting, retching, vigorous coughing

Question 9

Presentation of mallory Weiss tear

Answer 9

Hematemesis that stops spontaneously

Question 10

Diagnosis and treatment plan for Mallory Weiss tear

Answer 10

Diagnosis: EGD
TX: local epinepherine or cauterization of tear, endoscopic clipping or angiographic embolization

Question 11

Treatment plan for esophageal varices

Answer 11

Emergent endoscopy w/in 12 hours
Endoscopic ligation
Octreotide
Nonselective BB is 1st line for secondary prophylaxis
TIPS procedure for recurrent bleeds or advanced liver disease