Upper GI Bleed

Question 1

Where can an upper GI bleed come from?

Answer 1

• Oesophagus
• Stomach
• Duodenum

Question 2

What can cause an upper GI bleed?

Answer 2

• Varices
• Mallory-Weiss tear
• Ulcers
• Cancers

Question 3

How may bleeds present?

Answer 3

• Stained sputum
• Coffe-ground
• Haematemesis
• Melaena

Question 4

What score can grade an upper GI bleed?

Answer 4

Glasgow-Blatchford Score

Question 5

What are the parameters of a Glasgow-Blatchford Score?

Answer 5

• Drop in Hb
• Rise in Urea
• Hypotension
• Tachycardia
• Melaena
• Syncope

Question 6

What Glasgow-Blatchford Score indicates high risk?

Answer 6

Greater than 0

Question 7

What score can be used post-endoscopy?

Answer 7

Rockall Score

Question 8

How are Upper GI Bleeds treated?

Answer 8

ABATED

A-E approach
Bloods
Access (large bore cannulae)
Transfuse
Endoscopy (urgent 24 hours)
Drugs (stop anti-coags and NSAIDs)

Question 9

What bloods should be done and why?

Answer 9

• FBC (anaemia, plat)
• UsEs (Urea)
• Coag (INR)
• LFTs (Varices)
• XMatch (2 units)

Question 10

What should you transfuse with in a big bleed?

Answer 10

Blood and FFP

Question 11

What can excess blood transfusion cause?

Answer 11

TRALI (Transfusion Related Lung Injury)

Question 12

How are varices treated?

Answer 12

• Terlipressin

- Prophylactic antibiotics

Question 13

What is the definitive treatment in an UGI bleed?

Answer 13

OGD and intervention

Question 14

What should be stopped prior to OGD?

Answer 14

PPI