Gastrointestinal Bleeding Management Guidelines
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Questions and Answers

What is the primary reason why routine placement of a nasogastric tube is not recommended in patients with suspected upper gastrointestinal bleeding?

  • It fails to reliably provide useful data to guide management and is associated with unnecessary patient discomfort and potential complications. (correct)
  • It can lead to further exacerbation of the bleeding episode.
  • It is not effective in identifying the source of the bleeding.
  • It is an invasive procedure that carries a high risk of patient mortality.

    • In patients older than 35 years with upper gastrointestinal bleeding, what is the primary reason for performing an early electrocardiogram (ECG)?

  • To monitor for any changes in cardiac activity that may occur during the bleeding episode.
  • To assess the patient's overall cardiovascular health and risk of complications.
  • To identify any underlying cardiac conditions that may be contributing to the bleeding episode.
  • Patients with upper gastrointestinal bleeding and coronary disease may develop an acute coronary syndrome that presents with atypical symptoms, such as nausea and abdominal discomfort. (correct)

    • What is the significance of a blood urea nitrogen (BUN) to creatinine (Cr) ratio greater than 35 in patients with upper gastrointestinal bleeding?

  • It is 90% specific for upper gastrointestinal bleeding. (correct)
  • It is a poor indicator of upper gastrointestinal bleeding and should not be used to guide management.
  • It is 90% sensitive for upper gastrointestinal bleeding.
  • It can be used to rule out upper gastrointestinal bleeding.

    • What is the recommended transfusion threshold for stable patients without known coronary artery disease who are experiencing upper gastrointestinal bleeding?

    <p>Transfusion should be initiated when the hemoglobin level is less than 8 g/dL.</p> Signup and view all the answers

    Which of the following pharmacologic therapies is recommended for patients with cirrhosis and suspected esophageal varices who are experiencing upper gastrointestinal bleeding?

    <p>Octreotide and antibiotics.</p> Signup and view all the answers

    What is the recommended approach for patients with exsanguinating (severe) upper gastrointestinal bleeding?

    <p>Emergent transfusion of untyped packed red blood cells.</p> Signup and view all the answers

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