GIB

Upper GIB

100

Most common cause of Upper GIB

What is peptic ulcer disease

200

What is it called when pancreatic pseucyst erodes into vessel causing bleeding into pancreatic duct?

What is Hemosuccus pancreaticus?

300

Should I place a central line or a large bore IV into patient with hemodynamically unstable GIB?

What is 18gauge IV and up

400

If ASA is being used for primary prevention of CVD, should it be continued after GIB? What if it's being used for secondary prevention of CVD? 

If primary, discontinue. If secondary, then discontinue for 3 days then promptly resume after hemostasis secured. 

500

What is the role of NG lavage in treatment of upper GIB?

What is the definition of USELESS?

Lower GIB

100

What is the most common cause of lower GIB?

What are hemorrhoids...(eat plants not meat)

200

Which test should be ordered for hemodynamically unstable patients if concern for lower GIB?

What is CT angiography?

300

Which two groups of patients are at highest risk of AV malformations causing lower GIB?

- What are elderly patients

- What are pts on AC

400

Post polypectomy bleeding risk increases after polyps of which size are removed?

What is 2cm and greater?

500

What critical information is part of a complete history in patient with suspected lower GIB?

- onset of symptoms, duration, character

- medication history, including dosage

- hx of colonoscopies and possible interventions 

- personal medical history, including risk factor for liver disease

Small Bowel GIB

100

What is the most common cause of small bowel bleeding?

What is angiodysplasia?

200

What is the preferred test for evaluating stable pts with suspected small bowel bleeding (after normal EGD and colonoscopy)? 

What is wireless capsule endoscopy?

300

What are the chances a second-look EGD or colonoscopy will reveal source when first-look did not show a source?

What is up to 25%?

400

What role does hormonal therapy have in the medical management of small bowel bleeding?

What is the definition of NONE

500

What critical information is part of complete history in patient with suspected small bowel GIB?

• Include q regarding NSAID use, aortic aneurysm repair (which raises concern for aortoenteric fistula), necrotizing pancreatitis (which causes hemosuccus pancreaticus), or liver damage (trauma, tumor, recent biopsy causing hemobilia)
• Assess for skin lesions; mucocutaneous telangiectasia (heredtiary hemorrhagic telangiectasia aka Osler-Weber-Rendu syndrome), or dermatitis herpetiformis (Celiac disease)

MISC

100

Bleeding from which part of the GI tract carries the highest mortality? (upper, lower, small bowel) 

What is UGIB

200

Which type of lesion can cause recurrent, massive bleeding without a clear source

What is Dieulafoy Lesion?

300

What is the goal Hgb in treating hemodynamically unstable upper GIB from esophageal varices, and why?

7. Overtransfusion can precipitate variceal rebleeding due to increased portal pressure. 

400

What is the role of Octreotide in variceal hemorrhage? What is the duration of therapy?

decreases splanchnic blood flow and lowers portal pressure; start before EGD and continue 3 to 5 days after

500

What is the name of syndrome in patient with angiodysplasia and aortic stenosis, and what surgery do they need?

What is Heyde syndrome? What is valvular replacement?