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PRACTICE GUIDELINES

Continuing Medical Education Questions: September 2015

DeVault, Kenneth R MD, FACG

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American Journal of Gastroenterology: September 2015 - Volume 110 - Issue 9 - p 1288
doi: 10.1038/ajg.2015.256
  • Free

Questions:

  1. According to this guideline, which one of the following patients should be considered to have obscure GI bleeding?
    • A. A patient with a large hiatal hernia, some mild erosions in the gastric body, and iron deficiency anemia.
    • B. A patient with anemia, normal endoscopy, and colonoscopy, but with several arteriovenous malformations, noted on small bowel video capsule endoscopy (VCE).
    • C. A patient with anemia, but normal endoscopy, colonoscopy, and small bowel VCE.
    • D. A patient with iron deficiency anemia and melena.
  2. Which one of the following statements is correct regarding to the management of small bowel bleeding?
    • A. A second look endoscopy is rarely useful in a patient with melena.
    • B. VCE should always be performed before deep enteroscopy unless it is contraindicated.
    • C. A small bowel X-ray or computed tomography enterography should always be performed before VCE.
    • D. Given the advent of VCE and devices to perform deep enteroscopy, push enteroscopy should no longer be performed.
  3. Which one of the following statements is correct regarding to the management of small bowel bleeding?
    • A. In a patient with an iron-deficiency anemia that is correctable with oral iron, small bowel AVMs found on VCE should still be ablated, because they will eventually bleed.
    • B. Aortic valve replacement should not be considered in patients with small bowel bleeding and aortic stenosis unless there is a cardiovascular indication.
    • C. Magnetic resonance angiography is superior to CT angiography in patients with suspected small bowel bleeding.
    • D. Endoscopic tattooing can aid in the localization of a bleeding site if surgery is required.
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