Intracranial Hemorrhage and Gastrointestinal Issues Quiz
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Questions and Answers

What is the most common cause of intracranial hemorrhage?

  • Trauma (correct)
  • Motor Vehicle Accidents
  • Falls
  • Assault

Epidural hemorrhage typically occurs in the subdural space.

False (B)

Name two clinical features of acute subdural hemorrhage.

Brief LOC and coma

Intracranial hemorrhages can lead to an increase in _____, causing compression of brain tissue.

<p>ICP</p> Signup and view all the answers

Which blood vessel is primarily affected in an epidural hemorrhage?

<p>Middle meningeal artery (A)</p> Signup and view all the answers

Match the intracranial hemorrhage types with their descriptions:

<p>Epidural hemorrhage = Bleeding between skull and dura mater Subdural hemorrhage = Bleeding between dura and arachnoid mater Subarachnoid hemorrhage = Bleeding in the space surrounding the brain Intracerebral hemorrhage = Bleeding within the brain tissue</p> Signup and view all the answers

Subdural hemorrhage results in a rapid worsening of condition.

<p>False (B)</p> Signup and view all the answers

What is a potential consequence of untreated intracranial hemorrhage?

<p>Death</p> Signup and view all the answers

What is the most common symptom of gastric ulcers?

<p>Epigastric pain (D)</p> Signup and view all the answers

Gastrointestinal bleeding from the lower GI tract is more common than bleeding from the upper GI tract.

<p>False (B)</p> Signup and view all the answers

What is a common symptom associated with gastric outlet obstruction due to a chronic duodenal ulcer?

<p>Fullness and bloating</p> Signup and view all the answers

Acute Kidney Injury (AKI) is defined as a sudden decline in ______ filtration function.

<p>renal</p> Signup and view all the answers

Which of the following is NOT a complication of ulcers?

<p>Diabetes mellitus (A)</p> Signup and view all the answers

What is a common effect of obstruction in the renal system?

<p>Metabolic acidosis (A)</p> Signup and view all the answers

Match the GI bleeding causes with their respective locations:

<p>Oesophagitis = Oesophagus Gastric ulcer = Stomach Duodenal ulcer = Small intestines Diverticulitis = Large intestines</p> Signup and view all the answers

Name one symptom that may indicate significant blood loss in an acute GI bleed.

<p>Hematemesis</p> Signup and view all the answers

Prerenal causes of acute kidney injury (AKI) are most commonly due to structural damage to the nephrons.

<p>False (B)</p> Signup and view all the answers

The risk of death from an acute GI bleed is between _________ and _________ percent.

<p>5%, 30%</p> Signup and view all the answers

What is a key function of the kidneys in regulating electrolyte balance?

<p>Regulates sodium, potassium, calcium, and iron levels.</p> Signup and view all the answers

Acute tubular necrosis (ATN) is categorized under ______ causes of acute kidney injury.

<p>Intrinsic</p> Signup and view all the answers

Which of the following is an intrinsic cause of acute kidney injury?

<p>Acute tubular necrosis (B)</p> Signup and view all the answers

Match the following causes of AKI with their categories:

<p>Dehydration = Prerenal Acute tubular necrosis = Intrinsic Renal obstruction = Postrenal Septic shock = Prerenal</p> Signup and view all the answers

What is the most common type of peptic ulcer?

<p>Duodenal ulcer (A)</p> Signup and view all the answers

Obstructive causes of kidney injury are the most common type of acute kidney injury.

<p>False (B)</p> Signup and view all the answers

What hormone do the kidneys produce that regulates blood pressure?

<p>Renin</p> Signup and view all the answers

Peptic ulcers can only occur in the stomach and duodenum.

<p>True (A)</p> Signup and view all the answers

What role does mucus production play in the stomach?

<p>Mucus protects the stomach lining from gastric acid.</p> Signup and view all the answers

___________ is a bacteria commonly associated with peptic ulcers.

<p>H.pylori</p> Signup and view all the answers

Match the following aggressive factors with their impact on peptic ulcers:

<p>NSAIDs = Compromise mucosal defenses H.pylori infection = Impair bicarbonate secretion Alcohol = Increase acid production Smoking = Increase risk of ulcer formation</p> Signup and view all the answers

Which of the following factors is NOT a risk factor for peptic ulcers?

<p>Low acid secretion (A)</p> Signup and view all the answers

Rapid cell turnover in the gastric epithelium is beneficial for repairing damaged cells.

<p>True (A)</p> Signup and view all the answers

What happens when the balance between gastric acid secretion and mucosal defenses is disrupted?

<p>Peptic ulcers develop due to cell injury and inflammation.</p> Signup and view all the answers

What is the most common type of cerebral artery involved in infarction?

<p>Middle Cerebral Artery (MCA) (A)</p> Signup and view all the answers

Diabetes Mellitus can only occur as a result of decreased secretion of insulin.

<p>False (B)</p> Signup and view all the answers

What fasting blood glucose level is considered diabetic?

<p>7 mmol/L or more</p> Signup and view all the answers

In diabetes, the body compensates for decreased insulin by signalling the liver to increase __________.

<p>gluconeogenesis</p> Signup and view all the answers

Match the types of Diabetes Mellitus with their characteristics:

<p>Type 1 DM = Autoimmune destruction of insulin-producing cells Type 2 DM = Insulin resistance and relative insulin deficiency Gestational DM = Diabetes that occurs during pregnancy Other specific types = Diabetes due to conditions like pancreatitis</p> Signup and view all the answers

Which of the following is NOT a chronic effect of Diabetes Mellitus?

<p>Decreased insulin secretion (A)</p> Signup and view all the answers

Osmotic diuresis occurs in diabetes when glucose levels exceed the renal tubular capacity.

<p>True (A)</p> Signup and view all the answers

What characterizes the chronic complications of Diabetes Mellitus?

<p>Damage to blood vessels (angiopathy)</p> Signup and view all the answers

What is a common cause of chronic subdural hemorrhage in elderly individuals?

<p>Falls or minor injuries (A)</p> Signup and view all the answers

Subarachnoid hemorrhage causes bleeding that is slow as it is venous.

<p>False (B)</p> Signup and view all the answers

What is the management required for chronic subdural hemorrhage?

<p>Surgical evacuation of bleed</p> Signup and view all the answers

In subarachnoid hemorrhage, the bleeding occurs in the ______ space.

<p>subarachnoid</p> Signup and view all the answers

Match the type of hemorrhage with its characteristics:

<p>Chronic Subdural Haemorrhage = Slow accumulation of venous blood, common minor headaches Subarachnoid Haemorrhage = Sudden severe headache, rapid arterial bleeding Decerebrate Rigidity = Bad prognosis, associated with cerebral injury Cerebrovascular Accident (Stroke) = Disruption to cerebral blood flow due to thromboembolism</p> Signup and view all the answers

Which clinical feature is NOT commonly associated with chronic subdural hemorrhage?

<p>Severe headache (A)</p> Signup and view all the answers

The CT scan of a chronic subdural hemorrhage shows a hyperdense area that crosses the midline.

<p>False (B)</p> Signup and view all the answers

Identify one condition that may lead to increased intracranial pressure (ICP) as a result of a stroke.

<p>Cerebral edema</p> Signup and view all the answers

Flashcards

Intracranial Haemorrhage

Bleeding inside the skull, usually caused by damaged blood vessels.

Increased ICP

The buildup of blood inside the skull puts pressure on the brain.

Brain Herniation

A serious condition where parts of the brain are squeezed out of place.

Epidural Haemorrhage

Bleeding outside the brain tissue, between the skull and the dura mater.

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Subdural Haemorrhage

Bleeding between the dura mater and the arachnoid mater, often caused by vein damage.

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Intracerebral Haemorrhage

Bleeding inside the brain tissue, usually caused by damaged arteries.

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Intraventricular Haemorrhage

Bleeding in the ventricles, fluid-filled spaces inside the brain.

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Lucid Interval

A brief loss of consciousness, often followed by a period of alertness before symptoms worsen.

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Chronic Subdural Haemorrhage

A type of brain bleed that occurs in the space between the dura mater and arachnoid mater, often caused by falls or minor injuries in elderly individuals.

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Cause of Chronic Subdural Haemorrhage

The bridging veins in the dura mater are torn due to rotational or acceleration/deceleration forces, leading to a slow bleed.

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Subarachnoid Haemorrhage

A collection of blood in the subarachnoid space, often caused by trauma or ruptured aneurysms.

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Thromboembolism

A blood clot or blockage in a cerebral artery, leading to a disruption in blood flow to the brain.

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Ruptured Artery (Stroke)

A ruptured cerebral artery, also leading to disrupted blood flow to the brain.

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Ischemic Cascade

A series of events that occur in the brain cells after a stroke, resulting in cell death.

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Decreased ATP

Lack of oxygen in the brain due to disrupted blood flow, leading to reduced cellular energy production.

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Sodium-Potassium Pump Failure

The breakdown of the sodium-potassium pump in brain cells due to decreased ATP, resulting in cell swelling and edema.

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Diabetes Mellitus

A chronic metabolic disorder characterized by high blood sugar levels resulting from either inadequate insulin production, resistance to insulin, or both.

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Type 1 Diabetes

A type of diabetes where the body does not produce enough insulin due to an autoimmune attack on the pancreas.

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Type 2 Diabetes

A type of diabetes where the body becomes resistant to insulin, leading to high blood sugar levels.

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Gestational Diabetes

A type of diabetes that develops during pregnancy due to hormonal changes.

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Diabetic Angiopathy

Damage to blood vessels caused by high blood sugar levels over a long period of time.

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Glucosuria

A condition where blood glucose levels are too high, leading to the kidneys releasing glucose in the urine.

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Polydipsia

Increased thirst caused by the loss of water through urination when blood sugar is high.

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Polyphagia

Increased hunger due to the cells not being able to use glucose for energy.

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What are peptic ulcers?

Peptic ulcers are sores in the lining of the stomach or duodenum, caused by stomach acid damaging the protective lining.

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What is a duodenal ulcer?

The most common type of peptic ulcer, occurring in the first part of the small intestine.

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What is a gastric ulcer?

A peptic ulcer occurring in the stomach, less common than duodenal ulcers.

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What is the role of mucus in the stomach?

A protective layer of mucus covers the stomach lining to prevent contact with acidic digestive juices.

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How does bicarbonate protect the stomach?

Bicarbonate neutralizes acid, creating an alkaline environment to protect the digestive system.

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What is the role of prostaglandins in the stomach?

Prostaglandins promote blood flow, mucus production, and cell repair, contributing to a healthy stomach lining.

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How do tight junctions protect the stomach?

Tight junctions between stomach cells prevent acid from leaking out, maintaining a protective barrier.

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How does the stomach lining repair itself?

The stomach lining constantly renews itself, replacing damaged cells and maintaining protection.

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What is a common symptom of a duodenal ulcer?

A burning or gnawing sensation in the upper abdomen that occurs a few hours after meals.

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Where does most gastrointestinal bleeding occur?

Bleeding from the upper gastrointestinal tract (from the mouth to the small intestine) is four times more common than bleeding from the lower gastrointestinal tract (from the large intestine to the anus).

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What is acute kidney injury (AKI)?

A sudden or rapid decrease in the kidneys' ability to filter waste products from the blood.

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What is hematemesis?

Vomiting of blood.

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What is melena?

Passing of black, sticky, digested blood in stool.

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What is hematochezia?

Passage of bright red blood in the stool.

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What is esophagitis?

Bleeding from the esophagus due to swelling and inflammation.

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What is acute erosive gastritis?

Bleeding from the stomach due to inflammation and erosion of the stomach lining.

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Acute Kidney Injury (AKI)

A condition where the kidneys are unable to filter waste products from the blood effectively, leading to a buildup of toxins and fluid in the body.

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Obstructive AKI

A buildup of pressure in the kidneys due to obstruction in the urinary tract, leading to damage and dysfunction.

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Prerenal AKI

A type of AKI caused by inadequate blood flow to the kidneys, leading to damage and dysfunction.

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Intrinsic AKI

A type of AKI caused by direct damage to the kidney tissue, such as inflammation or toxins.

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Postrenal AKI

A type of AKI caused by obstruction of the urinary tract after the kidneys, leading to damage and dysfunction.

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Hypovolemia

The most common cause of prerenal AKI, it's a reduction in the volume of blood circulating throughout the body.

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Hypotension

Low blood pressure, which can occur due to various factors such as hemorrhage or shock, and can lead to reduced blood flow to the kidneys.

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Renal Artery Disease

A medical condition that involves a decrease in blood flow to the kidneys due to damage or blockage of the renal arteries or aorta.

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Study Notes

Intracranial Haemorrhages

  • Intracranial haemorrhage is bleeding within the cranial cavity, caused by ruptures or tears of blood vessels (meningeal vessels, dural veins, cerebral arteries).
  • This is a serious medical emergency, as the blood buildup increases intracranial pressure (ICP).
  • Increased ICP can compress delicate brain tissue, restrict blood supply, and lead to brain herniation (parts of the brain being squeezed past structures in the skull).
  • Trauma is the most common cause.

Classifications of Intracranial Haemorrhages

  • Extra-axial (outside brain tissue) haemorrhages:
    • Epidural haemorrhage
    • Subdural haemorrhage (acute and chronic)
    • Subarachnoid haemorrhage
  • Intra-axial (inside brain tissue) haemorrhages:
    • Intracerebral haemorrhage
    • Intraventricular haemorrhage

Epidural Haemorrhage

  • Cause: Primarily due to motor vehicle accidents (MVAs), falls, assaults, or direct blunt trauma (temporal bone fractures).
  • Location: Bleeding in the epidural space (between the skull and dura mater).
  • Blood vessel: Middle meningeal artery.
  • Speed of bleeding: Rapid (arterial).
  • Clinical features:
    • Brief loss of consciousness (LOC) followed by a short "lucid interval."
    • Rapid mental status deterioration as ICP rises.
    • Worsening headache.
    • Hemiparesis (weakness on one side of the body).
    • Seizures.
    • Fixed/dilated pupils.
    • Coma and death if untreated
  • CT scan: Biconvex lens-shaped hyperdense area. It doesn't cross the midline.
  • Management: Usually requires surgical evacuation of the bleed.

Acute Subdural Haemorrhage

  • Cause: Often associated with MVAs, falls, or assaults involving acceleration/deceleration or rotational injuries. Skull fractures also possible.
  • Location: Bleeding in the subdural space (between the dura mater and arachnoid mater).
  • Blood vessel: Dural and bridging veins.
  • Speed of bleeding: Slower (venous).
  • Clinical features:
    • Brief LOC, followed by a longer "lucid interval"
    • Possible coma, and death if untreated
    • Decerebrate rigidity possible
    • May present with coma at A&E
  • CT scan: Crescent-shaped hyperdense area. Usually doesn't cross the midline
  • Management: Usually requires surgical evacuation of the bleed.

Chronic Subdural Haemorrhage

  • Cause: Falls or minor injuries, especially in elderly people (>60). Shrinking brain (atrophy) can tear bridging veins.
  • Location: Subdural space.
  • Blood vessel: Bridging dural veins.
  • Speed of bleeding: Slow (venous).
  • Clinical features:
    • Gradual onset of neurological symptoms like headaches, personality changes, fluctuating drowsiness etc.
  • CT scan: Crescent-shaped hyperdense area, does not cross midline.
  • Management: Usually requires surgical evacuation of the bleed.

Subarachnoid Haemorrhage

  • Cause: Blunt trauma, acceleration/deceleration injuries, penetrating injuries, or a ruptured congenital aneurysm
  • Location: Subarachnoid space, around the circle of Willis.
  • Blood vessel: Cerebral arteries.
  • Speed of bleeding: Fast (arterial).
  • Clinical features:
    • Sudden severe headache
    • Vomiting
    • Seizures
    • Deteriorating mental status
    • Meningism signs (e.g., stiff neck, photophobia)
  • CT scan: Focal hyperdense area in sulci
  • Management: No surgical option (External ventricular drain to reduce ICP). Treat increased ICP and reduce secondary brain injury.

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Intracranial Haemorrhages PDF

Description

Test your knowledge on the causes and complications related to intracranial hemorrhage as well as gastrointestinal conditions like gastric ulcers and their symptoms. This quiz covers various clinical features, the impact on kidney function, and distinguishing between upper and lower GI tract bleeding. Challenge yourself on these critical medical topics.

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