GI bleeds

Question 1

Acute Upper GI- Eti

Answer 1

• 50% > 60
• Self limited in 80%
• Ulcers (NSAIDs), esophageal varices, mallory weiss tears

Question 2

Acute Upper GI- Sx

Answer 2

Hematemeisis- bright red or coffee grounds

• Melena
• Postural hypotension & tachycardia

Question 3

Acute Upper GI- Dx

Answer 3

• Assess volume status

- Endoscopy

Question 4

Acute Upper GI- Tx

Answer 4

• Packed RBCs if nexxessary
• Desmopressin
• PPIs

Question 5

Acute lower GI- Eti

Answer 5

• Less common, arise in colon
• older men
• 50 = diverticulosis, angiectasias, malig.

Question 6

Acute lower GI- Sx

Answer 6

Hematochezia- BRB per rectum

Question 7

Acute lower GI- Dx

Answer 7

Colonoscopy on stable pt

Question 8

Acute lower GI- Tx

Answer 8

• PPIs

- Embolization- cautery, epi, clips

Question 9

Occult GI- Eti

Answer 9

• GI bleed not apparent
• Iron deficiency anemia
• Premenopausal women
• Can occur anywhere in GI tract

Question 10

Occult GI- Sx

Answer 10

• Incidental finding on FOBT

- No change in stool

Question 11

Occult GI- Dx

Answer 11

• Colorectal ca screening

- Celiac work up

Question 12

Occult GI- Tx

Answer 12

Tx underlying cause- commonly remains unexplained