Question

A 68-year-old man presents to the emergency department with melaena and dizziness. He is hypotensive and tachycardic; Hb is 78 g/L. After initial resuscitation with IV fluids and blood, what is the most appropriate next step in management of his upper gastrointestinal bleed?

Accepted Answer

Arrange urgent upper endoscopy within 24 hours after resuscitation

Answer

Start high-dose oral proton pump inhibitor and discharge once stable

Answer

Prescribe oral iron and review in clinic

Answer

Order a CT scan of the abdomen first

Answer

Delay endoscopy for 7 days while the ulcer heals

Practice question

A 68-year-old man presents to the emergency department with melaena and dizziness. He is hypotensive and tachycardic; Hb is 78 g/L. After initial resuscitation with IV fluids and blood, what is the most appropriate next step in management of his upper gastrointestinal bleed?