GI bleeding

Question 1

What may cause GI bleeding?

Answer 1

• duodenal ulcer
• gastric erosions
• gastric ulcer
• varices

Question 2

What does the rockall risk scoring system measure?

Answer 2

• guidance for upper GI bleeding

- age, pulse, SB, co-morbidity

Question 3

How might you treat a bleeding peptic ulcer?

Answer 3

• endoscopic treatment
• injection of adrenaline
• heater probe coagulation
• combinations
• clips
• haemospray

Question 4

How does haemo-spray work?

Answer 4

• when in contact with the blood the powder absorbs water

- acts to create a mechanical barrier over the bleed

Question 5

What may be a common clinical history in acute variceal bleeding?

Answer 5

• cirrhosis

- alcoholism

Question 6

Treatment of varices?

Answer 6

• coagulopathy
• CVP monitioring
• antibiotics

Question 7

What part of the oesophagus does varices mainly effect?

Answer 7

• lower 1/3rd of oesophagus

Question 8

What is the prophylaxis treatment of varices and cirrhosis?

Answer 8

• non-selective beta blocker (propranolol)

Question 9

What is the immediate management of a lower GI bleed?

Answer 9

• take bloods
• IV access, 2 large bore IV cannulas
• give blood transfusion if required
• o2 therapy
• surgery if bleeding persists

Question 10

What reduces re-bleeding rates?

Answer 10

• IV omerprazole

- then infusion

Question 11

What causes a mallory-weirs tear?

Answer 11

• sudden increased in intra-abdominal pressure
• heavy bout of coughing, or vomiting
• alcoholics

Question 12

Mesenteric ischemia effects what part of the GI tract?

Answer 12

• small intestine

Question 13

Colonic ischamia effects what part of the GI tract?

Answer 13

• large intestine