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level: Level 1

Questions and Answers List

Question	Answer
A is totally wrong. Prepare for scoldings. B. Do assessment first. Check for VS first. BP, PR.	Patient presented with PR bleed. What should you do? A. inform MO B. do assessment first. If you choose this, what assessment you should do first?
Do DRE. Look out for any bleed/growth. Bleed - brownish, melena, fresh melena or fresh PR Bleed? Double gloves ye. if haematinic stool, do not worries much.	Pt presented with PR Bleed. You check VS. What's next?
1. FBC - to check Hb 2. coag profile - to check for any bleeding tendencies 3. GSH/GXM. If noted nappy of pt presented with full of blood then prepare for GXM.	VS and DRE were done for pt with PR bleed. What's next? What ix you want to do?
1. Insert 2 large bore canullae (orange/black) 2. IVD NS if pt bp drop or tachy 3. IV Pantoprazole 80mg STAT then BD or infusion 8mg/H (PPI)	What's the plan?
Inform MO surgical. MO surgical will inform gastro specialist (if tertiary hosp). Sometimes HO surgical need to inform MO gastro directly. Then, scope will be arranged for pt. Make sure to take note what his/her forest classification is.	You did your plan. What now?
It is to monitor severity of bleeding. 1- active bleeding 1a - spurting bleed, 1b - oozing bleed 2 - recent bleed 2a - visible vessel, 2b - presence of blood clot, 2c - hematinin base 3 - clean base	What is forest classification?