Gastroenterology
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| show | Hemorrhoids
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| Common, painless and can be massive, caused from an erosion into penetrating artery from the diverticulum | show 🗑
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| What is the most common cause of upper GI bleed | show 🗑
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| Cause of esophageal and gastric varices | show 🗑
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| Longitudinal mucosal tear in the cardioesophageal region, caused by repeated retching | show 🗑
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| show | Arteriovenous malformations
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| Spider angiomata, palmer erythema, jaundice, and gynecomastia are seen in __ | show 🗑
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| Petechiae and purpura seen in __ | show 🗑
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| show | Rule out causes that can mimic GI bleed such as epistaxis
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| show | angiography
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| Can only be diagnostic but are more sensitive than angiography and require a bleeding rate of only .1ml/min | show 🗑
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| Is diagnostic and therapeutic and more accurate than bleeding scans and angiography | show 🗑
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| For Class __ bleed: replace volume with crystalloid | show 🗑
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| For Class __ bleed: replace volume with crystalloid and blood | show 🗑
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| Hemorrhaging is broken down into how many categories by the ACS | show 🗑
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| Class __ hemorrhage involves up to 15% of blood volume. There is typically no change in vital signs and fluid resuscitation is not usually necessary | show 🗑
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| Class _ hemorrhage involves 15-30% of total blood volume. A patient is often tachy, narrowed pulse pressure. Peripheral vasoconstriction, pale cool skin, slight changes in behavior, volume resuscitation with crystalloids | show 🗑
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| Class __ hemorrhage involves loss of 30-40% of blood volume; pt’s BP drops, HR increases, peripheral perfusion decreases (prolonged cap refill), mental status worsens; crystalloid & blood transfusions usually necessary | show 🗑
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| Class __ hemorrhage involves loss of >40% of blood volume; limit of body’s compensation is reached and aggressive resuscitation is required to prevent death | show 🗑
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| __ ulcers do not extend through the muscularis mucosa | show 🗑
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| show | 10-20
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| show | Cigarette smoking
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| show | Gnawing, aching or burning epigastric pain
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| show | Epigastric tenderness
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| Inhibit gastric acid secretion, equally as effective as antacids with better compliance due to decreased frequency of doses | show 🗑
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| show | PPI
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| show | Sucralfate
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| Prostaglandin E1 analogue which acts as natural prostaglandin in the body | show 🗑
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| show | Gastroenteritis
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| show | upper
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| What is the most common cause of acute lower GI bleeding? | show 🗑
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| what is the most important lab test for a patient with a significant GI bleed | show 🗑
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| when is surgical treatment for hemorrhoids indicated | show 🗑
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| treatment of choice for patients with pseudomembranous colitis | show 🗑
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| show | vancomycin
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| show | antidiarrheal agents
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| Meckler triad | show 🗑
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| show | ligament of Treitz
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| show | NSAIDs; Steroids (in setting of NSAID); Warfarin; Heparin, Enoxaparin; Clopidogrel (Plavix)
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| 3 most common causes of upper GI bleed | show 🗑
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| 3 most common causes of lower GI bleed | show 🗑
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| Resting Tachycardia: blood loss = | show 🗑
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| show | Significant loss, 10-20% of intravascular volume
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| show | Loss of 20-40% of intravascular volume
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| Chronic GI blood loss: defined by: | show 🗑
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| show | Resuscitation; goal = normal vital sx; 2 lg bore IVs; ICU monitoring if needed
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| Dieulafoy’s Lesion = | show 🗑
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| Mallory-Weiss tear: | show 🗑
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| show | Anoscopy; Flexible Sigmoidoscopy; Colonoscopy; Tagged red blood cell scan; Angiography
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| Diverticular bleeding: sxs and location | show 🗑
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| show | help localize bleeding; pre-test for angiography; detects bleeding (0.1 to 0.5 mL/min; less sensitive w/inc bowel motility); no tx capability
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| show | Caution w/renal failure given IV contrast load
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| LGIB: Angiography: utility | show 🗑
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| Diverticular disease etiology | show 🗑
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| show | colonoscopy / sigmoidoscopy
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| show | Xray (free abd air); CT (to dx abscess / inflammation); scopy to r/o or confirm dx; hemorrhage: 99mTc-labeled RBC scan, mesenteric angiogram, scintigraphy
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| show | mild: PO Flagyl + (Cipro or SMX-TMP); hospitalize if no response to tx -> IV Abx
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| Causes of upper GI bleed | show 🗑
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| Meds assoc w/GI bleed | show 🗑
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| 3 most common causes of upper GI bleed | show 🗑
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| 3 most common causes of lower GI bleed | show 🗑
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| Dieulafoy Lesion = | show 🗑
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| show | Acute, painless hematochezia; most bleeds are right sided
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| show | herniation of mucosa through the muscular wall of the intestine
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| Most common cause of massive lower GI bleed in elderly: | show 🗑
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| show | 800 mL
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| show | Stabilize VS (eg, fluid resuscitation, 20 ga IV x2); determine upper vs lower; scope +/- NGT for blood; ID source and tx
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| If EGD & colonoscopy are neg, consider: | show 🗑
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| show | 99mTc-labeled RBC scan, scintigraphy
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| show | vascular ectasias (flat lesion, hard to visualize)
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Created by:
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