1. What is one of the most common complications of octreotide?
c) GI bleeding
2. Which is the most common cause of significant UGI bleed in children?
b) Esophageal Varices
c) Duodenal ulcers
d) Foreign body ingestion
3. Which of the following is not standard treatment for the patient with an UGI bleed?
a) IV PPI
b) 2 large bore IV's
c) Type and screen/cross
d) Iced saline nasogastric lavage
ANSWERS & EXPLANATIONS
1. A. Octreotide mimics somatostatin and thus reduces splanchnic blood flow. It also is a potent inhibitor of insulin, glucagon, and growth hormone, which promotes hyperglycemia.
2. B. Esophageal varices are the most common cause of significant UGI bleed in children
3. D While nasogastric lavage is recommended in patients with suspected UGI bleed (only after discussion with GI if suspecting variceal bleed), iced saline is no longer recommended as it may lead to hypothermia and impaired coagulation without evidence for vasoconstrictive benefit