GI Bleeding Flashcards Preview

1st Year Medicine > GI Bleeding > Flashcards

Flashcards in GI Bleeding Deck (13)
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1
Q

How do we manage an acute GI bleed presentation?

A

ABC, protect the airway, IV access with large bore cannulas. Fluids.

2
Q

What is the 100 rule for poor prognostic group in a GI bleed?
What others are also included in this group?

A

Systolic under 100
Pulse over 100
HB under 100g/L

Aged over 60
Comorbid disease
Postural hypotension.

3
Q

What is the blatchford score?

A

Is used to assess GI bleed patients status. Uses BP, Hb, urea etc.

4
Q

What is stigmata of recent haemorrhage?

A

Active bleeding or oozing or an overlying clot or visible vessel.

5
Q

What are the endoscopic treatments of peptic ulcers?

A

Injection, heater probe coagulation, clips and haemospray.

Can be given 1:10000 adrenaline to cessation bleeding during the procedure.

6
Q

How does haemospray work?

A

When comes into contact with blood, the powder absorbs water, which forms a barrier over the bleeding site.

7
Q

What are risk factors for bleeding oesophageal varices?

A

Portal pressure of over 12mmHg
Varices extending over 25% into the lumen.
Presence of red signs
The degree of liver failure.

8
Q

When should we suspect varices in a bleeder?

A

Known history of varices or cirrhosis.
History: chronic alcohol excess, chronic viral hepatitis infection, metabolic or autoimmune liver disease.
On examination: stigmata of chronic liver diseases such as spider naevi, ascites, jaundice, palmar erythema leukonychia and encephalopathy.

9
Q

How is haemostasis achieved in bleeding varices?

A
Terlipressin (vasopressin analogue)
Endoscopic variceal ligation.
Sclerotherapy
Sengstaken-blakemore tube
TIPS procedure.
10
Q

What does terlipressin do?

A

Predominantly splanchnic vasoconstriction and has a beneficial effect on renal perfusion.
Superior to vasopressin and somatostatin.

11
Q

What veins cause oesophageal varices?

A

The periesophageal venous plexus.

12
Q

What is a TIPS procedure?

What is it used for?

A

Burrow through the liver to place a shunt between the portal vein and one of the hepatic veins to try and reduce portal pressure.
Known cirrhosis liver with uncontrollable bleeding oesophageal varices.

13
Q

What are the causes of GI bleeding from the most to least common?

A
Duodenal ulcer
Gastric erosions
Gastric ulcer
Varies
Malory Weiss tear
Oesophagitis
Etc.