week 9 discussion questions

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1. When is angiography considered as an initial test in patients with suspected lower gastrointestinal bleeding (LGIB), and what are its primary indications?

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2. What are the options for further workup of patients with ongoing bleeding and negative endoscopy in the context of gastrointestinal bleeding, and what is the role of CT angiography (CTA) in this scenario?

3. What is the purpose of a nuclear bleeding scan (RBC scintigraphy) in the diagnosis of gastrointestinal bleeding, and what bleeding volume can it detect?

4. Why should virtual endoscopy not be ordered for the detection of the causes of gastrointestinal bleeding, and what limitations does it have?

5. In cases where upper and lower endoscopies are unrevealing, what is the most likely source of gastrointestinal bleeding, and how can small bowel bleeding be evaluated?

6. What is the most important initial step in the management of severe gastrointestinal bleeding, and what should be done if a patient is experiencing a high volume bleed?

7. When should fresh frozen plasma, prothrombin concentrate complex, and cryoprecipitate be given in the management of gastrointestinal bleeding, and what are their indications?