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12 Cards in this Set
- Front
- Back
Name 5 common causes of an upper GI bleed:
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1) Duodenal ulcers
2) Gastric ulcers 3) Acute gastritis 4) Gastroesophageal varices 5) Mallory-Weiss syndrome |
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When speaking of "upper" GI bleeds, how far down the digestive tract are we talking?
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From mouth to end of duodenum (ligament of Treitz)
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What is a Mallory-Weiss tear?
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Tear at the junction of the esophagus and stomach caused by severe retching or vomiting.
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Name a test (not endoscopy or imaging) that can confirm that the source of the bleeding is upper rather than lower?
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NG tube aspiration (if blood comes up, we know it's in the upper GI tract)
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What can you do during endoscopy to resolve bleeding?
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Cauterization, close varices, inject epinephrine
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What is the most useful diagnostic technique employed for upper GI bleeding?
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Endoscopy
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Name two non-laboratory tests you would do to investigate upper GI bleeding.
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1) NG aspiration
2) Endoscopy |
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What blood tests would you want when investigating an upper GI bleed?
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CBC to check for anemia, coags, (INR, PTT), LFTs to investigate liver disease, blood type and match,
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Why might creatinine be elevated in patients with upper GI bleeds?
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Because of absorption of blood in the stomach.
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What is the initial treatment for upper GI bleeds?
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Fluid resuscitation
NG drainage Interventional endoscopy |
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How does GI bleeding present?
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Blood can pass through the mouth as hematemesis/coffee ground emesis or through the anus as hematochezia/melena/fecal occult blood.
In the first scenario the likely source of the blood is an upper GI bleed. The differential diagnosis includes: -acute gastritis -duodenal ulcers -gastric ulcers -gastroesophageal varices -Mallory-Weiss syndrome In the case of blood passing per rectum the source may be either an upper or lower GI bleed. A differential diagnosis for lower GI bleeding includes: Colorectal cancer Arteriovascular malformations Diverticular disease Inflammatory bowel disease Anorectal disease Meckel's diverticulum Ischemic colitis |
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Describe the workup for a suspected GI bleed.
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1) Bloodwork:
CBC, lytes, BUN/creatinine, coagulation studies (INR and PTT), blood type and cross match 2) Nasogastric tube suction -If you get blood up, it's upper GI. If you don't, it doesn't rule out upper GI. 3) Endoscopy for upper GI bleed 4) Angiography (e.g. CT angiogram) 5) Endoscopy |