Upper GI haemorrhage — MCCQE Part 1 MCQ

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ModerateBleeding (GI)Upper GI haemorrhageMCCQE Part 1

A 60-year-old man on ASA and naproxen has severe epigastric pain and haematemesis. BP 90/60, HR 120, Hb 72. Most appropriate initial management?

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Correct answer: A — IV fluids, blood transfusion, and urgent upper endoscopy

Acute upper GI bleed with haemodynamic instability: IV fluids + transfuse (target Hb >=70) + IV PPI + urgent endoscopy within 12-24h. Octreotide for variceal bleeding, not peptic ulcer. Discontinue NSAIDs permanently.

Reference: CAG Upper GI Bleeding