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VARICES ESOFAGICAS

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VARICES ESOFAGICAS
RONDA JHR
Quiz by RONDA JHR, updated more than 1 year ago
RONDA JHR
Created by RONDA JHR about 5 years ago
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Resource summary

Question 1

Question
Varices appeared to be the source of bleeding in 50 to 90 percent of patients with cirrhosis
Answer
  • True
  • False

Question 2

Question
In patients with cirrhosis, any upper gastrointestinal bleeding associated with hemodynamic changes should be considered to be variceal in origin until proven otherwise.
Answer
  • True
  • False

Question 3

Question
Early rebleeding – Bleeding that occurs >120 hours but <6 weeks from time zero,
Answer
  • True
  • False

Question 4

Question
Only 50 percent of patients with variceal hemorrhage stop bleeding spontaneously
Answer
  • True
  • False

Question 5

Question
Cuando la presión portal pasa de 10 mmHg se incrementa potencialmente el desarrollo de colaterales.
Answer
  • True
  • False

Question 6

Question
Se 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.
Answer
  • True
  • False

Question 7

Question
a hepatic venous pressure gradient >20 mmHg is associated with a greater risk of continued or recurrent bleeding
Answer
  • True
  • False

Question 8

Question
50 percent of all early rebleeding episodes occur within the first 10 days
Answer
  • True
  • False

Question 9

Question
The 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
Answer
  • True
  • False

Question 10

Question
Acute bleeding from varices is associated with approximately 15 to 20 percent 30-day mortality
Answer
  • True
  • False

Question 11

Question
Platelet counts often drop within the first 48 hours after a bleed and may necessitate platelet transfusions if values below 50,000/mm3
Answer
  • True
  • False

Question 12

Question
Bacterial infections are present in up to 20 percent of patients with cirrhosis who are hospitalized with gastrointestinal bleeding
Answer
  • True
  • False

Question 13

Question
effectiveness of prophylactic antibiotics in patients with cirrhosis hospitalized for bleeding suggest an overall reduction in infectious complications and decreased mortality
Answer
  • True
  • False

Question 14

Question
A 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
Answer
  • True
  • False

Question 15

Question
patients with cirrhosis who present with upper GI bleeding (from varices or other causes) should be given prophylactic antibiotics, preferably before endoscopy
Answer
  • True
  • False

Question 16

Question
fOR PREVENTION OF INFECTIONS, intravenous ceftriaxone (1 g/day for seven days), which was superior to norfloxacin in a randomized controlled trial [
Answer
  • True
  • False

Question 17

Question
Short-term (maximum seven days) antibiotic prophylaxis should be instituted in any patient with cirrhosis and GI hemorrhage.
Answer
  • True
  • False

Question 18

Question
Among 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
Answer
  • True
  • False

Question 19

Question
Treatment with endoscopic variceal ligation decreases the risk of rebleeding to approximately 30 percent, and the risk of death to approximately 25 percent.
Answer
  • True
  • False

Question 20

Question
Endoscopic 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
Answer
  • True
  • False

Question 21

Question
Pharmacologic therapy should not be delayed pending confirmation that the source of bleeding is indeed from varices
Answer
  • True
  • False

Question 22

Question
pharmacologic therapy typically consists of an octreotide bolus (50 mcg intravenous [IV]) followed by a continuous infusion (50 mcg IV per hour).
Answer
  • True
  • False

Question 23

Question
Terlipressin 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
Answer
  • True
  • False

Question 24

Question
Pharmacologic therapy is typically continued for three to five days following cessation of bleeding
Answer
  • True
  • False

Question 25

Question
The goal should be to perform an upper endoscopy after fluid resuscitation and within 12 hours of presentation
Answer
  • True
  • False

Question 26

Question
If the bleeding cannot be controlled endoscopically, treatment options include transjugular intrahepatic portosystemic shunt (TIPS) placement or surgical shunting
Answer
  • True
  • False

Question 27

Question
terlipressin is the only agent individually shown to reduce mortality
Answer
  • True
  • False

Question 28

Question
— 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].
Answer
  • True
  • False

Question 29

Question
terlipressin is released in a slow and sustained manner, permitting its administration via intermittent injections.
Answer
  • True
  • False

Question 30

Question
terlipressin has been associated with hyponatremia,
Answer
  • True
  • False

Question 31

Question
A 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
Answer
  • True
  • False

Question 32

Question
Somatostatin inhibits the release of vasodilator hormones such as glucagon [20], indirectly causing splanchnic vasoconstriction and decreased portal inflow.
Answer
  • True
  • False

Question 33

Question
the most consistently delocteotride observed is the decrease in collateral flow (azygos flow)
Answer
  • True
  • False

Question 34

Question
While somatostatin and octreotide help achieve hemostasis and prevent rebleeding, neither has a clearly established benefit on mortality [
Answer
  • True
  • False

Question 35

Question
A 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
Answer
  • True
  • False
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