Bleeding:

1) Nasal bleeding: trauma, pick nose, foreign objects, dry membranes (winter and
weather conditions), high altitude, desert Arizona
First Aid: ice and pressure, caderization
S/E: decrease in mucos secretions and increase in infection and increase in bleeding (dry
mucosal membranes)

Treatment: Saline solution” good treatment nasal lavage

2) oral bleeding: esophagitis (serious) stomach (coffee grounds appearance)

Hepatitis C – cirrhosis esophageal varices, alcoholics, esophageal cancer barrett’s
syndrome,
Causes of Stomach appearance oral bleeding: hemorrhage from ucler or NSAID use
Gastric Cancer, Peptic Ulcer Disease, Trauma

3) Blood from Lungs: trauma, cancer, hemothorax, infection, adcanced pneumonia,

TB, ddx with ST/Lu (coffee or red)
4) Anus: Fissures (not much more pain), hemorrhoids, colorectal cancer,
polyps/diverticulitis (perforation into Abdomin) Upper GI bleed through anus
should be black (occult blood)
Occult stool test: use popsicle stick smear feces on portion of testing kit in 3 places on the
envelope colour changes turns blue --- indicates blood there

False Positive: menses, lots of rare meals (no meat for 24-48 hours prior to test), lots of
Iron supplementation at high doses, vit C increases to 500 mg, Vegetable beets (no for 24-
48 hours)

5) Vaginal Bleeding: menstration supposed to regular but

a. Irregular blood : peritoneal bleed or perforation or trauma
b. Ectopic pregnancy (most in first trimester), can lead to rupture of fallopian
tube, excess bleeding can be caused by implantation (this can occure
normally when implantation happens in uterus)
c. Infections (STI’s, HPV defiantly causes bleeding from the cervix
especially after intercourse, IUDs
d. Fibroids (profuse + longer) Meorrhagia clots with fibroids, Metorrhagia
(not during normal menses)
e. Endometrial polyps/CA
f. Ovarian Cancer: Post menopausal is the normal age range (mid 30’s-50’s)
other symptoms include gas bloating and pain. These symptoms mimic
normal PMS symptoms and menstral blood; diagnostic ultrasound and
biopsy is the only way to truly diagnosis this disease usually found at
stage 3 or 4. generally poor prognosis; generally cancer tissue is epithelial
lining from retro flow RISK FACTORS: Nuliparous (no child), fertility
treatments/drugs (CLOMID – drug forces ovulation) Metastic: to lung
bone brain
 g. Urinary bladder cancer: risk factor smoking, female
h. Miscarriage:looks like menses with heavy period (happens 50 percent of
pregnancy)
6) Male Urethral Blood: Kidney stones, STI’s (not common) but there is a chance of
capillary rupture (runners and other athletics) blood will be FRANK, prostates
(usually not common), TURP scrapping of prostate to reduce inflammation and
allowing to increase urine flow but side effect is bleeding, KI and BL irritation
from Radiology can also cause frank bleeding