Quiz
VARICES ESOFAGICAS
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Questions in this quiz (35)
1Varices appeared to be the source of bleeding in 50 to 90 percent of patients with cirrhosis
- ATrue
- BFalse
2In patients with cirrhosis, any upper gastrointestinal bleeding associated with hemodynamic changes should be considered to be variceal in origin until proven otherwise.
- ATrue
- BFalse
3Early rebleeding – Bleeding that occurs >120 hours but <6 weeks from time zero,
- ATrue
- BFalse
4Only 50 percent of patients with variceal hemorrhage stop bleeding spontaneously
- ATrue
- BFalse
5Cuando la presión portal pasa de 10 mmHg se incrementa potencialmente el desarrollo de colaterales.
- ATrue
- BFalse
6Se define como hipertensión portal un gradiente de presión venosa hepática mayor a 5 mmHg, y el valor de 12 mmHg es un factor de riesgo para predecir hemorragia variceal.
- ATrue
- BFalse
7a hepatic venous pressure gradient >20 mmHg is associated with a greater risk of continued or recurrent bleeding
- ATrue
- BFalse
850 percent of all early rebleeding episodes occur within the first 10 days
- ATrue
- BFalse
9The risk of bleeding and of death in patients who survive six weeks is similar to that in patients with cirrhosis of equivalent severity who have never bled
- ATrue
- BFalse
10Acute bleeding from varices is associated with approximately 15 to 20 percent 30-day mortality
- ATrue
- BFalse
11Platelet counts often drop within the first 48 hours after a bleed and may necessitate platelet transfusions if values below 50,000/mm3
- ATrue
- BFalse
12Bacterial infections are present in up to 20 percent of patients with cirrhosis who are hospitalized with gastrointestinal bleeding
- ATrue
- BFalse
13effectiveness of prophylactic antibiotics in patients with cirrhosis hospitalized for bleeding suggest an overall reduction in infectious complications and decreased mortality
- ATrue
- BFalse
14A systematic review that included eight placebo-controlled trials with a total of 864 patients found the antibiotics were associated with a significant reduction in mortality (RR 0.75, 95% CI 0.55 to 0.95) and bacterial infections (RR 0.40, 95% CI 0.32 to 0.51) including bacteremia, pneumonia, spontaneous bacterial peritonitis, and urinary tract infections
- ATrue
- BFalse
15patients with cirrhosis who present with upper GI bleeding (from varices or other causes) should be given prophylactic antibiotics, preferably before endoscopy
- ATrue
- BFalse
16fOR PREVENTION OF INFECTIONS, intravenous ceftriaxone (1 g/day for seven days), which was superior to norfloxacin in a randomized controlled trial [
- ATrue
- BFalse
17Short-term (maximum seven days) antibiotic prophylaxis should be instituted in any patient with cirrhosis and GI hemorrhage.
- ATrue
- BFalse
18Among patients with cirrhosis, varices form at a rate of 5 to 15 percent per year, and one-third of patients with varices will develop variceal hemorrhage
- ATrue
- BFalse
19Treatment with endoscopic variceal ligation decreases the risk of rebleeding to approximately 30 percent, and the risk of death to approximately 25 percent.
- ATrue
- BFalse
20Endoscopic sclerotherapy is associated with a decrease in the risk of rebleeding to 40 to 50 percent, and a decrease in the risk of death to 30 to 60 percent
- ATrue
- BFalse
21Pharmacologic therapy should not be delayed pending confirmation that the source of bleeding is indeed from varices
- ATrue
- BFalse
22pharmacologic therapy typically consists of an octreotide bolus (50 mcg intravenous [IV]) followed by a continuous infusion (50 mcg IV per hour).
- ATrue
- BFalse
23Terlipressin is administered at an initial dose of 2 mg IV every four hours and can be titrated down to 1 mg IV every four hours once hemorrhage is controlled
- ATrue
- BFalse
24Pharmacologic therapy is typically continued for three to five days following cessation of bleeding
- ATrue
- BFalse
25The goal should be to perform an upper endoscopy after fluid resuscitation and within 12 hours of presentation
- ATrue
- BFalse
26If the bleeding cannot be controlled endoscopically, treatment options include transjugular intrahepatic portosystemic shunt (TIPS) placement or surgical shunting
- ATrue
- BFalse
27terlipressin is the only agent individually shown to reduce mortality
- ATrue
- BFalse
28— Vasopressin can achieve initial hemostasis in 60 to 80 percent of patients, but has only marginal effects on early rebleeding episodes and does not improve survival from active variceal hemorrhage [12].
- ATrue
- BFalse
29terlipressin is released in a slow and sustained manner, permitting its administration via intermittent injections.
- ATrue
- BFalse
30terlipressin has been associated with hyponatremia,
- ATrue
- BFalse
31A study comparing the acute hemodynamic effects of terlipressin to octreotide in stable patients with cirrhosis found a sustained effect of terlipressin on portal pressure and blood flow compared with only a transient effect from octreotide
- ATrue
- BFalse
32Somatostatin inhibits the release of vasodilator hormones such as glucagon [20], indirectly causing splanchnic vasoconstriction and decreased portal inflow.
- ATrue
- BFalse
33the most consistently delocteotride observed is the decrease in collateral flow (azygos flow)
- ATrue
- BFalse
34While somatostatin and octreotide help achieve hemostasis and prevent rebleeding, neither has a clearly established benefit on mortality [
- ATrue
- BFalse
35A systematic review found that combination therapy with somatostatin or octreotide and endoscopic variceal ligation improved the five-day success rate compared with endoscopic variceal ligation alone
- ATrue
- BFalse
Information
- Description
- VARICES ESOFAGICAS
- Author
- RONDA JHR
- Language
- Español
- Views
- 10
- History
- Created on 3 Apr 2019 · updated on 3 Apr 2019
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