76yof presents with 4 days of dark melanotic stools. What should you grab to bring with you before you go into the room?
Answer
guaiac card
NG Tube
developer
blood consent form
2U PRBC
Speculum
culture swabs
lube
Question 2
Question
76yof presents with 4 days of dark melanotic stools. You brought in your stuff with you... like a boss... What do you want to ask this patient about?
Answer
NSAID use
pepto bismol use
menstrual/vaginal bleeding
anticoagulant use
easy bruising/bleeding
favorite color
vaccination history
Question 3
Question
76yof presents with 4 days of dark melanotic stools. You do a rectal exam, it's guaiac positive. You also hear a late-peaking crescendo-decrescendo systolic murmur. What is a likely cause of her GI bleeding?
Answer
longstanding aortic stenosis --> GI AV malformations
profound anemia --> AV malformations
longstanding mitral regurg --> esophageal varices
H. pylori infection --> peptic ulcer disease
hemorrhoids
Question 4
Question
76yof presents with 4 days of dark melanotic stools. Guaiac positive stool. VS are stable, patient is not in distress, she is not on anticoagulants, has no cardiac history. Her hemoglobin returns at 6.9, what do you do?
Answer
transfuse 1U PRBC
watch and wait
give TXA
admit to the ICU and let them deal with it.
Question 5
Question
42yom w/ history of EtOH abuse presents to ED with massive hematemesis. BP 64/22. Patient's mental status is declining. What do you need set up/at the bedside in order to intubate this patient?
Answer
video and traditional laryngoscopes
push dose pressors
suction
BVM
pressor drip
central line
2 large bore IVs or IOs
bougie
NG tube
octreotide
Question 6
Question
You have successfully intubated the 42yom w/ massive hematemesis. What medications should be started now in order to reduce morbidity and mortality?