Question

A 60-year-old man with cirrhosis due to chronic hepatitis C is seen in hepatology clinic. He is Child-Pugh class B and has no history of variceal bleeding. According to Canadian guidance on portal hypertension, what is the most appropriate strategy to prevent first variceal haemorrhage?

Accepted Answer

Start non-selective beta-blocker therapy or schedule endoscopic variceal ligation if medium/large varices are present on endoscopy.

Answer

No specific prophylaxis is required until he bleeds.

Answer

Begin prophylactic antibiotics indefinitely.

Answer

Initiate warfarin anticoagulation.

Answer

Recommend low-dose acetylsalicylic acid for portal vein thrombosis prevention.

Practice question

A 60-year-old man with cirrhosis due to chronic hepatitis C is seen in hepatology clinic. He is Child-Pugh class B and has no history of variceal bleeding. According to Canadian guidance on portal hypertension, what is the most appropriate strategy to prevent first variceal haemorrhage?