A quiz testing your knowledge of the causes and complications of GI bleeds!
Reviewed by: awaiting review
Approach to the patient with Gastrointestinal Bleeding
STEM 1, QUESTION 1 OF 5
An 18-year old male has been diagnosed with extensive ulcerative colitis after presenting to his GP with a 3-week history of bloody diarrhoea and tiredness.
Chronic blood loss can lead to anaemia. In anaemia caused by chronic blood loss, what would the red blood cells look like on a blood smear?
Microcytic and hypochromic
Macrocytic and hypochromic
Normocytic and normochromic
Microcytic and normochromic
Normocytic and hypochromic
STEM 1, QUESTION 2 OF 5Extensive colitis is diagnosed when inflammation extends proximally beyond which anatomical structure?
Major duodenal papilla
STEM 1, QUESTION 3 OF 5Which of the following is NOT a typical endoscopic finding of ulcerative colitis?
Only the colon is affected
Mucosa which bleeds easily
STEM 1, QUESTION 4 OF 5Which of the following is NOT a typical extra-intestinal manifestation of ulcerative colitis?
Metabolic bone disease
STEM 1, QUESTION 5 OF 5The patient returns to his GP with a 1-month history of lower back pain and stiffness. The pain is reported to be worse in the morning, lasting for around 40 minutes after getting out of bed. The pain gets better with movement and responds to NSAIDs. Which blood test should the GP consider performing now?
Antinuclear antibody (ANA)
Anti-Ro and anti-La antibody
STEM 2, QUESTION 1 OF 5
A patient in hospital with liver cirrhosis has suffered a sudden episode of vomiting large quantities of bright red blood due to ruptured oesophageal varices. Following the episode, the patient is unable to obey commands for movement but quickly moves his hand towards pain. He opens his eyes when someone calls his name and can maintain a confused conversation.
What is the patient's GCS score?
STEM 2, QUESTION 2 OF 5Which anatomical feature separates upper and lower GI bleeds?
The major duodenal papilla
The gastro-oesophageal junction
The suspensory ligament of the duodenum (ligament of Treitz)
The hepatic flexure
STEM 2, QUESTION 3 OF 5Which scoring system should be used as the first risk assessment for patients with acute upper GI bleeds?
Glasgow-Blatchford Bleeding score
The full Rockall score
STEM 2, QUESTION 4 OF 5Terlipressin is offered to the patient. Which of the following statements is true about terlipressin?
Terlipressin is given orally
Terlipressin is a vasopressin analogue
Terlipressin is a vasopressin antagonist
Terlipressin is given intra-muscularly
Terlipressin is an aldosterone-receptor antagonist
STEM 2, QUESTION 5 OF 5Once stabilised, the patient discusses their chronic heavy alcohol use. Wernicke encephalopathy is a neurological condition which can be associated with alcohol misuse. Deficiency in which vitamin causes this condition?