Upper GI Bleed Flashcards Preview

Inflammation > Upper GI Bleed > Flashcards

Flashcards in Upper GI Bleed Deck (21)
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1
Q

Haematemesis is

A

Blood in vomit

2
Q

How to assess airway

A

Clear/on oxygen/ patient talking/ need to keep reassessing in view of vomiting

3
Q

How to assess breathing

A

Look listen and feel/ chest expansions + sats

4
Q

Assess circulation

A

Looks pale/ peripheral temp/ cap refill

5
Q

Immediate management for GI bleed

A

Call help

2 large bore IV cannula

Take bloods

IV fluids

ABG/ lactate/HB/electrolytes

Catherter

Keep NBM

15 minute obs

6
Q

Every GI bleed needs which examination

A

Rectal exam

7
Q

Treatment of GI. Bleed

A

Stop offending drugs

Give blood if needed

Correct clotting (less than 1.5 INR)

Platelet transfusion if under 50

Consider antibiotics if risk f aspiration or varices

8
Q

Causes of UGIbleeds

A

Malloy Weiss tear
Oseophagitis

Oesophageal varices

Peptic ulcer

Malignancy

Drugs

Angiodysplasia

Aortoenetric fistula

9
Q

Before administering specific treatment you should make sure that?

A

You know if it’s a varicella or non varicella (peptic ulcer)

10
Q

If variceal then

A

Give terlipressin(always have ecg before the terlipressin)

11
Q

Terlipressin is analogue do and does

A

Analogue of vasopressin

Causes vasoconstriction

12
Q

Careful with first dose of terlipressin why

A

ECG before and after first dose as it can cause heart attacks in prone people

13
Q

Non variceal treatment

A

Give pantoprazole infusion - 80 mg IV stat then 8mg/hr for 72 hours

14
Q

Risk stratification is

A

Blatch- ford score

15
Q

Blatchford score is between ?

When is 50% risk of needing an intervention

A

0-6

3

16
Q

What can’t blatchford predict

A

Morality

17
Q

When is endoscopy needed

A

-Severe bleed 6+
Urgent OGDonce resuscitated
Will need protected airway

Mild/moderate bleed

OGD within 24hrs of admission

18
Q

Which score used for morality

A

Rock all score

19
Q

After OGD

A

Continue PP8, terlipressin,antibiotics as advised

Rock all score

Clear fluid after an hour

Light diet after 6 hours

Monitor signs of rebleeding

20
Q

Other things to consider post OGD

A

Peptic ulcer-

Check and eradicate H.pylori
Omeprazole 40mg OD/BD 8 weeks

Repeat score in 6-8 weeks

  • varices

Propranolol or carvediol
Endoscopic banding every 2-4 weeks

21
Q

Peptic ulcer is risk of

A

Malignancy

Need to stop smoking