Acute Gastrointestinal Bleeding Flashcards Preview

07. Year 2: Alimentary System > Acute Gastrointestinal Bleeding > Flashcards

Flashcards in Acute Gastrointestinal Bleeding Deck (102)
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1

What is the incidence of GI bleed in the UK?

180/100000

2

What is the overall mortality of acute GI bleed?

10%

3

What mainly affects the outcomes of GI bleed?

Identification and promp management

4

Where can upper GI bleeding occur from?

Oesophagus

Stomach

Duodenum

 

anywhere proximal to ligament of Trietz

5

Where can lower GI bleeding occur from?

Bleeding distal to duodenum (jejunum, ileum, colon)

Distal to ligament of Trietz

6

What is the clinical presentation of upper GI bleed?

Haematemesis

Melaena

Elevated urea (digested blood turns haem into urea)

Dyspepsia, reflux, epigastric pain

7

What is the clinical presentation of lower GI bleeding?

Fresh blood/clots

Magenta stools

Normal urea (rarely elevated if proximal small bowel origin)

Typically painless

 

8

What can cause upper GI bleeds in the oesophagus?

Oesophageal ulcer

Oesophagitis

Oesophageal varices

Mallory Weiss Tear

Oesophageal malignancy

9

What can cause upper GI bleeds in the stomach?

Gastric ulcer

Gastritis

Gastric varices

Portal hypertensive gastropathy

Gastric malignancy

Dieulafoy

Angiodysplasia

10

Are duodenal ulcers or gastric ulcers more common?

Duodenal ulcers (75%)

11

What are risk factors for peptic ulcers?

Helicobacter pylori

NSAIDs/aspirin

Alcohol excess

Systemic illness (stress ulcers)

12

How does helicobacter pylori lead to gastric ulcers?

Produces urease -> amonia produced -> buffers gastric acid locally -> increased acid production

13

How does NSAIDs lead to gastric ulcers?

Prostaglandin production -> reduces mucus and bicarbonate excretion -> reduces physical defences

14

Why when a gastric ulcer is present is a repeat endoscopy indicated at 8 weeks?

They may have been sitting over a gastric carcinoma

15

What is Zollinger-Ellison syndrome also known as?

Gastrin-secreting pancreatic tumour

16

How does Zollinger-Ellison syndrome impact duodenal ulcers?

Causes poor healing of duodenal ulcers

17

What are the risk factors for gastritis and duodenitis similar to?

Risk factors for gastric and duodenal ulcer

18

What tends to cause gastritis and duodenitis to bleed?

Medical conditions

Anti-coagulants

Anti-platelets

19

What are examples of anti-coagulants?

Warfarin

Rivaroxaban

Apixaban

Dabigatran

LMWH

20

What are examples of anti-platelets?

Clipidogrel

Ticagrelor

21

What are risk factors for oesophagitis?

Reflux oesophagitis

Hiatus hernia

Alcohol

Biphosphonates

Systemic illness

22

When is oesophagitis most likely to have significant bleeding?

When on anti-platelets or anti-coagulatns

23

What are varices secondary to?

Portal hypertension, usually due to liver cirrhosis

24

What are varices?

Abnormally dilated collateral vessels

25

What are different types of varices?

Oesophageal (90%)

Gastric (8%)

Rectal and splenic (rare)

26

What are examples of upper GI malignancies?

Oesophageal cancer

Gastric cancer

27

What is a Mallory-Weiss tear?

Linear tear at oesophageal-gastric junction

28

What does a Mallory-Weiss tear follow a period of?

Vomiting and retching

29

What is Diuelafoy?

Submucosal arteriolar vessel eroding through mucosa

30

Where does Diuelafoy commonly occur?

Gastric fundus