Answers (Solved Papers)
What conditions should be considered in an adult presenting
with an upper GI bleed? - Correct Answers ✅1. Peptic ulcer
disease: Duodenal ulcers or Gastric ulcers
2. Varices
3. Mallory-weiss tears
4. Gastritis/esophagitis
5. Aortoenteric fistula
6. Malignancy
7. Angiodysplasia
What factors should be considered in the triage of upper GI
bleeding? - Correct Answers ✅1. Hemodynamic stability:
pulse, SBP
2. Hemoglobin level
3. BUN:Creatinine ratio
4. Symptoms: melena, syncope
5. Comorbidities: hepatic disease, cardiac failure
*Glasgow Blatchford score
*AIMS65: albumin, INR, AMS, SBP, age
What classes of medical therapy have a role in the treatment
of upper GI bleeds? - Correct Answers ✅1. PPIs (e.g.,
omeprazole, pantoprazole): prevent rebleeds
,MCCQE Study Set Exam Questions and
Answers (Solved Papers)
2. Prokinetics (e.g., erythromycin): improve visualization
3. Stomatostatin analogs (e.g., octreotide): variceal bleeds
4. Antibiotics : patients with cirrhosis
What benign causes of dark stool should be ruled-out before
considering a GI bleed? - Correct Answers ✅1. Iron
supplementation
2. Recent Pepto-bismol use
What laboratory investigations should be ordered for a
patient with a suspected GI bleed? - Correct Answers ✅1.
CBC
2. Coagulation: PTT/INR
3. Blood transfusion: group + screen (cross & type)
4. BUN/Cr (ration >10:1 suggests UGIB)
5. LFTs
*repeat labs in 4-6 hours to follow clinical course
Upper GI bleed + Epigastric or right upper quadrant pain
is suggestive of ________________________ - Correct Answers
✅Peptic ulcer disease
, MCCQE Study Set Exam Questions and
Answers (Solved Papers)
Upper GI bleed + Odynophagia, gastroesophageal reflux,
dysphagia
is suggestive of ________________________ - Correct Answers
✅Esophageal ulcer
Upper GI bleed + Emesis, retching, or coughing prior to
hematemesis
is suggestive of ________________________ - Correct Answers
✅Mallory-Weiss tear
(partial thickness tear)
Upper GI bleed + Jaundice, weakness, fatigue, anorexia,
abdominal distention
is suggestive of ________________________ - Correct Answers
✅Variceal hemorrhage or portal hypertensive gastropathy
Upper GI bleed + Dysphagia, early satiety, involuntary weight
loss, cachexia
is suggestive of ________________________ - Correct Answers
✅Malignancy
What are signs of hemodynamic instability on physical exam?
- Correct Answers ✅1. Orthostatic hypotension
(progressing to supine)
2. Resting tachycardia