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Patient has a GI bleed. Which of the following would indicate black stools?
a. Melena
b. Hematochezia
c. Hematemesis
Melena
A patient with a massive upper GI bleed who loses 1600 ml of blood may exhibit which symptoms?
a. HR 120
b. BP- 128/88
c. HR 80
d. BP- 134/98
A 25-year-old female is seen in ED for gastroparesis. She has 1 week history of nausea and vomiting. She reports multiple episodes of emesis and one episode of hematemesis. On PE, BP is 145/60 and HR 98
Most likely diagnosis?
a. Esophageal Varices
b. Mallory Weis Tear
c. Esophagitis
d. Gastric Cancer
Mallory Weis Tear
A 56-year-old female presents with sudden onset of bright red emesis, experiencing fatigue and dyspnea and is hypotensive. What is the next best step?
a. Surgery
b. IV fluids
c. Antibiotics
d. Outpatient follow up
B. IV Fluids
A 75-year-old man is hospitalized for sudden onset painless hematochezia that began 1 day ago. Denies nausea, vomiting, melena or abdominal pain. Denies medication changes. Patient has a previous history of diverticulosis and hypertension.
On physical exam, vital signs are WNL. On anorectal exam, fresh blood is seen. Cardiopulmonary exam is normal. Abdomen is soft and tender. No signs of liver disease.
Hgb- 8.8
BUN- 14
Most appropriate diagnostic test?
a. CT Angiography
b. Colonoscopy
c. Upper endoscopy
d. Angiography with embolization
B. Colonoscopy
A 60-year-old man presents with 4-day history of melena and hematemesis. He has chronic history of lower back pain. He takes some medication but cannot remember the name.
PE- BP 110/80, Pulse- 98, RR-18, O2- 97%
DRE- Melenic stool
Hgb -8 g/dL
Glasgow Blatchford score- 12
0.9% saline and IV PPI are initiated
Most appropriate management?
a. Endoscopy in 24 hrs
b. NG lavage
c. Discharge to outpatient
d. Blood transfusion
Endoscopy in 24 hours