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Documenti di Cultura
15.
2.
_____________________accounts
for 50% of upper GI bleeding;
Hemodynamic instability,
ongoing symptoms, inability to
clear bleeding with lavage, age
of 60
16.
males, elderly
(both upper and lower bleeds)
3.
Angiodysplasia Characterized by
17.
Hemobilia - caused by
4.
18.
history/risk factors;
ongoing hemorrhage
5.
Mesenteric ischemia
19.
history to take
20.
21.
every 4 hrs
C/C of Colitis
(whole section doesnt diff UC vs
Crohn's?)
abdominal cramps,
diarrheal stools containing
blood and mucopurulent
material, fever, weight
loss, anemia.
22.
How to Dx hematochezia
Proctoscopy to visualize
hemorrhoids
23.
How to Dx Meckel's
Diverticulum?
24.
25.
if hematochezia from
UPPER GI source...
26.
27.
smoking
alcohol
NSAIDS, aspirin
caffeine
28.
6.
7.
8.
9.
10.
11.
Hematemesis
hematochezia-bright red;
lower GI (sigmoid, rectum)
melena-tarry; upper GI
(stomach/duod)
12.
Colonic polyps
13.
14.
29.
is initial hematocrit
always low?
30.
Diverticular disease;
then angiodysplasia, colonic ulcers
Mallory-Weiss
Syndrome
32.
Mallory-Weiss
Syndrome also
reported following
33.
meckel's
diverticulum
34.
Meckel's
Diverticulum mc in
35.
meckel's
diverticulum pic
31.
36.
Meckel's
Diverticulum S&S
MOA of somatostatin
/ octreotide
38.
39.
Hemorrhoids
meckel's diverticulum
IBD,
polyps
angiodysplasia
diverticula
neoplasms
37.
40.
41.
42.
diverticula
IBD
neoplasms
43.
44.
Omeprazole or rabeprazole;
somatostatin; octreotide
45.
The presence of
telangiectasias of the skin
and lips may indicate
which disease?
Osler-Weber-Rendu disease
(hereditary hemorrhagic
telangiectasia) - AD disorder!
46.
shigella, campylobacter,
entamoeba histolytica, c. diff,
and salmonella
47.
No
48.
rectal prolapse
May result from straining at
stool. Patient passes blood and
mucus per rectum
-elderly and have chronic
constipation
49.
Hematemesis or hematochezia
Hypotension, tachy, shock
(or Postural hypotension,
lightheadedness)
50.
Tenderness to palpation in
the epigastrium is common
with what 2 diseases?
Gastritis
Peptic ulcer disease
51.
Treating colitis
52.
53.
54.
Treating esophageal
varices
NG tube, Octreotide
Sclerotherapy, band ligation,
Sengstaken-Blakemore tube
tamponades hemorrhage
55.
Treating hemobilia
56.
Treating hemorrhoids
57.
Treating Mallory-Weiss
Syndrome
58.
treating Meckel's
Diverticulum
59.
76.
Vigorous retching or
vomiting prior to onset of
hematemesis
60.
77.
61.
Treatment of angiodysplasia
Electrocoagulation,
embolization through
angiography
Hyperactive bowel
sounds (the blood
stimulates peristalsis)
78.
Massive hematemesis or
S/S of shock
79.
80.
Persistent hypotension
despite infusion of 2 L of
crystalloid
81.
82.
83.
LUQ;
burning pain - 40% of
bleeding pts may not
have pain prior to onset
of bleed
84.
85.
86.
87.
Shock or
Hx of cardiac or renal
dysfunction
88.
62.
Treatment of diverticulosis
Get a colonoscopy to
visualize area, may need
surgery if massive bleeding,
selective angiography with
embolization is also an
option for bleeding
Aortoenteric fistula
64.
Exsanguination
65.
Gastric erosions
66.
Potential life-threatening
upper GI bleed.
-Refer to GI
specialist/surgeon
63.
67.
Gastric lavage
rectal exam
68.
alcohol
ASA, NSAIDS
caffeine
69.
70.
Endoscopy
71.
<30%
72.
BUN
73.
Abdominal aneurysm
74.
Kaposi sarcoma,
lymphoma, cytomegalovirus
ulcerations
75.