Act as Internalist 👨🏻⚕️🫀🩺
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Papillary Muscle Rupture, Ventricular Septal Rupture & Ventricular Free Wall Rupture due to ACS
🟣Causes of Upper GI Bleeding:
(Above the ligament of Treitz — esophagus, stomach, duodenum)
1. Peptic Ulcer Disease (PUD) — 40–60% Most common cause of upper GI bleeding. Includes gastric and duodenal ulcers.
2. Esophageal Varices — 10–20% Second most common cause. Seen in liver cirrhosis and portal hypertension. High risk of severe bleeding.
3. Gastritis — 10–15%
Inflammation of the stomach lining, usually due to NSAIDs, alcohol, or infection.
4. Mallory-Weiss Tear — 5–10%
Mucosal tear at the gastroesophageal junction, usually after severe vomiting.
5. Esophagitis — 5–10%
Often caused by gastroesophageal reflux disease (GERD).
6. Malignancy — <5%
Cancers of the stomach, esophagus, or duodenum causing chronic or acute bleeding.
7. Dieulafoy’s Lesion / AVMs — <2%
Abnormal blood vessels that bleed suddenly and may be hard to detect on endoscopy.
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🟢Causes of Lower GI Bleeding:
(Below the ligament of Treitz — small bowel, colon, rectum)
1. Diverticulosis — Most common cause
Common in the elderly. Usually painless bleeding.
2. Angiodysplasia — Second most common cause
Vascular malformations, typically in the right colon.
3. Ischemic Colitis
Common in older adults. Causes abdominal pain with mild to moderate bloody diarrhea.
4. Hemorrhoids
Bright red bleeding, usually during or after defecation.
5. Colorectal Cancer / Polyps
May present with chronic, occult, or overt bleeding.
6. Inflammatory Bowel Disease (IBD)
Includes Crohn’s disease and Ulcerative colitis. Often causes bloody diarrhea.
🛑Remember
✅Beta blockers contraindication in treatment of decompensated heart failure unless failure due to
tachyarrhythmia.
cardio_NOT
Meningitis Signs.
• Brudzinski = Neck flexion → Hip & knee flexion.
• Kernig = Hip & knee 90° → Pain/resistance on knee extension.
